Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 4 3 2020 02 23 e80 e80 Ateeq Rahaman Department of Emergency Medicine, Hamad General Hospital, Doha, Qatar Al-Nuaimi Saad-Abdullah Department of Emergency Medicine, Hamad General Hospital, Doha, Qatar Kumar Suresh Department of Emergency Medicine, Hamad General Hospital, Doha, Qatar 2020 01 28 2020 02 17 Introduction: Spontaneous rupture of the urinary bladder (SRUB) is rare condition. It is often difficult to diagnose particularly in busy emergency department (ED). SRUB is usually secondary to an underlying pathology, but in extremely rare condition, it can be idiopathic. Significant morbidity and mortality can result from a missed or delayed diagnosis. Case presentation: We report a case of idiopathic SRUB in a young male presented with inability to pass urine and abdominal pain in the absence of prior trauma or alcohol intoxication. A bedside ultrasound was performed by the emergency physician (EP) to confirm his suspicion, which demonstrated free intra-peritoneal fluid. This expedited further workup and management. Emergency consultation to urologist on call was initiated, the diagnosis was confirmed by CT scan and the patient was taken to the theatre. Conclusion: We report this case as it is unique in presentation, very rare in occurrence and bedside US had expedited further workup and management. https://fem.tums.ac.ir/index.php/fem/article/view/340 https://fem.tums.ac.ir/index.php/fem/article/download/340/267