Presentation
Presented after being hit by a car. Hypovolemic shock, pelvic injuries.
Patient Data
There is diffusely decreased serosal detail and retroperitoneal detail. A large segment of the small bowel is corrugated. A urinary catheter has been placed but the urinary bladder is not identified. There is bilateral sacroiliac luxation, bilateral pubic fractures, a left ischial fracture, and a complete fracture of the left femoral neck. The right 13th rib is fractured.
Positive contrast media is injected through the urinary catheter. The contrast leaks freely into the peritoneal cavity. The pelvic urethra appears intact.
Uroabdomen. The cystogram study demonstrates bladder rupture. The wispy appearance to the retroperitoneal space is either due to hemorrhage or urine leakage from kidney or ureteral injury. Multiple pelvic fractures. Fracture of right 13th rib.
Case Discussion
The cystogram demonstrates the location of the urine leakage to be primarily urinary bladder, and the urethra appears intact. The ureters are not evaluated with this study.
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