Traumatic urethral transection

Case contributed by Mr Andrew Murphy

Presentation

Fall from a moving truck.

Patient Data

Age: 40 years
Gender: Male
X-ray

Multiple left-sided rib fractures, left clavicle fracture, left 9th transverse process fracture, small left haemopneumothorax with left ICC in situ.

 High-grade stenosis of the coeliac trunk with minor poststenotic dilatation

Complex pubic rami and left sacral ala fracture with evidence of blood within the urinary bladder and extensive pelvic haematoma.  Prominent enhancement at the left base of the penis may represent a vascular injury, however there is no significant change on portal venous and delayed phases.  This injury has high correlation with urethral injury.

X-ray

Urethrogram

The foley catheter with a balloon is inflated and lays in the fossa navicularis, around the level of the bulbous urethra diaphragm is an abrupt cut-off. There is extraperitoneal contrast extravasation and no evidence of it extending into the posterior urethra or the bladder.

This is evident of a traumatic urethral transection.

Case Discussion

Traumatic urethral transection secondary to pelvic fractures are not common, however have significant implications for the patient. The injury occurs most commonly at the level of the bulbomembranous junction, they are not caused by sharp edges of fracture fragments rather as a result of ligamentus rupture during pelvic-ring trauma.

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Case information

rID: 48983
Case created: 3rd Nov 2016
Last edited: 9th Dec 2016
System: Trauma
Inclusion in quiz mode: Included

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