Urinary bladder injury may result from either blunt or penetrating trauma. Ruptures of the urinary bladder are most frequently seen in multi-trauma patients with blunt injuries ¹.

Bladder injuries are classified into five types depending on the degree of wall injury and anatomic location ¹.

Type 1 represents simple bladder contusion, type 2 intraperitoneal rupture, type 3 an interstitial bladder injury, type 4 extraperitoneal rupture, which is distinguishable from a type 3 injury by the location of extravasated contrast material at cystography, and type 5 combined intraperitoneal and extraperitoneal rupture ^1,2.

Intraperitoneal bladder rupture occurs in approximately one-third of major bladder injuries. This injury is typically the result of a direct blow to the already distended bladder. The sudden rise in the intraluminal pressure of the bladder causes intraperitoneal rupture of the bladder dome. CT cystography demonstrates intraperitoneal contrast material around bowel loops, between mesenteric folds, and in the paracolic gutters ^1,2.

Intraperitoneal rupture requires surgical repair.