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Bladder rupture - intraperitoneal

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Pelvic trauma after motor vehicle accident.

Patient Data

Age: 20 years
Gender: Male
Fluoroscopy

Voiding cystourethrography (VCUG) shows extravasation of contrast media from the urinary bladder into the intraperitoneal space. Contrast extravasation is seen throughout the peritoneal cavity, not within the bowel loops. 

Fractures through the right iliopectineal line, acetabular roof and greater sciatic notch causing protrusio acetabuli and high riding femur.

Fracture line also is seen at the left superior pubic ramus.

Case Discussion

Intraperitoneal bladder rupture typically is the result of direct trauma to an already distended bladder. 

In this recent case, VCUG demonstrates intraperitoneal contrast material around bowel loops, between mesenteric folds, and in the paracolic gutters.

Surgical repair of the ruptured bladder was performed.

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