Presentation
Penetrating bullet injury of the pelvis.
Patient Data
Contrast media was instilled via the urinary catheter which showed leak of contrast anteriorly, laterally, and superiorly from the bladder wall full thickness rupture into the soft tissues of the pelvis and tracking through the pubic diastasis into the scrotum and along the pelvic sidewalls into the medial compartment of the thighs.
Small amount of contrast is also extravasated into the lower aspect of the rectus sheath.
A small amount of contrast is also extravasated intraperitoneally in the right para-colic gutter.
Minor subcutaneous stranding at the bullet entry site, fractured right greater trochanter and bilateral superior pubic rami (containing opacified urine) and bullet in the anterior left thigh.
Case Discussion
Bladder rupture can be intraperitoneal (treated with surgery) or extraperitoneal (treated with indwelling urinary catheter (IDC)) or both.
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