Distended urinary bladder and diverticulum-a rare cause of large-bowel obstruction

A 76-year-old man presented to the emergency department with diffuse abdominal pain and constipation. In the few months before this admission the patient had complained of strenuous micturition. The diagnostic work-up included a plain abdominal radiograph and an abdominal computed tomography scan that revealed large-bowel obstruction with a rare cause. The colonic obstruction was secondary to external compression of the rectosigmoid colon against the sacrum by a distended bladder and diverticulum. The immediate management was insertion of an indwelling urinary catheter that resulted in quick relief of the obstruction. Later the patient underwent surgery to remove an enlarged benign prostatic adenoma, which was the underlying cause of the bladder distention.