Intraperitoneal bladder rupture

Discussion:

Important observations from this case:

  • ascites with pelvic fractures should make you strongly suspicious for intraperitoneal bladder rupture
  • you can carefully review the bladder dome and see the large, linear area of rupture even if delayed images are not obtained. This can be best seen on sagittal images, and is the most common location of injury 
  • delayed images help to confirm free intraperitoneal spillage of contrast opacified urine. However, a false negative study would be possible if the bladder did not contain sufficient volume  
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