Presentation
Presented after being hit by a car. Suspected uroabdomen.
Patient Data
On the survey images, a urinary catheter is present in the urethra and the region of the urinary bladder. The bladder is not visualized, and there is poor peritoneal detail. There is subluxation of the left sacroiliac joint, with cranial displacement of the ilium with respect to the sacrum. There is asymmetry of the pelvic symphysis with a step defect between the left and right pubis. There is a fracture extending across the left ischiatic table. The caudoventral abdominal body wall is thickened and indistinct, with an angular mineral opacity superimposed over the soft tissues of this region.
A urethrogram was performed with gradual retraction of the urinary catheter into the urethra. The contrast medium immediately distributes into the peritoneal space, and the bladder is not visible.
Traumatic bladder rupture and pelvic fractures.
Case Discussion
The bladder rupture was repaired during abdominal surgery. The urethrocystogram was useful in ruling out any tear to the urethra, which helps with surgical planning. Pelvic trauma and fractures can damage the ureters, bladder, and urethra.
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