Extraperitoneal bladder rupture

Case contributed by Dr Craig Hacking

Presentation

Pelvic trauma post fall from 8m. Initial trauma CT shows S1 fracture through the left sacral ala involving the left L5-S1 facet joint and left sacroiliac joint inferiorly with diastasis of the pubic symphysis. Fluid in pelvis and scrotum ? bladder rupture

Patient Data

Age: 55-60 years
Gender: Male

Water soluble contrast agent injected via the indwelling catheter.

Diastasis of the pubic symphysis and sacral fractures are again demonstrated. There is extravasation of contrast to the left anteroinferior aspect of the bladder, with contrast tracking through the pubic diastasis into the scrotum and along the left pelvic sidewall into the medial compartment of the left thigh. Small amount of contrast is also extravasated into the lower aspect of the rectus sheath. Intrinsic linear high density along the medial aspect of the left rectus abdominis is noted.

No intraperitoneal contrast extravasation. Extraperitoneal haematoma is also demonstrated in the presacral region.

Conclusion

Extraperitoneal bladder rupture with contrast extravasating into the lower rectus sheath, scrotum and left thigh.

Case Discussion

Bladder rupture can be intraperiotoneal (treated with surgery) or extraperitoneal (treated with IDC) or both.

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Case information

rID: 40145
Case created: 9th Oct 2015
Last edited: 18th Aug 2017
Systems: Urogenital, Trauma
Inclusion in quiz mode: Included

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