Case of the Month: September, 2011, Page 3

Answer: B. Extraperitoneal bladder rupture

( Click here for larger image. )

( Click here for larger image. )

An additional image reveals the point of contrast extravasation in the left anterior bladder wall.

Diagnosis: Traumatic pelvic fractures with associated extraperitoneal bladder rupture.

Key points

  • Extraperitoneal bladder rupture leads to extravasation into the space of Retzius
    • Accounts for 62% of bladder injuries, most common type
    • Usually due to pelvic fractures
  • Intraperitoneal bladder rupture typically occurs at the dome of the bladder
    • Accounts for 25% of bladder injuries, more common in children
    • Due to direct blow to abdomen with a distended bladder
  • Treatment options
    • Antibiotics and catheter drainage
    • Surgical repair
    • Follow-up cystography in 10 days after either conservative or surgical treatment
< Previous PageView Our Case of the Month Archives