IS Case 157: Extraperitoneal traumatic bladder leak

Devang Butani, MD


Imaging Sciences URMC 2008
Publication Date: 2009-05-21

History

Patient is a 58-year-old male with clinical evidence of acute uretheral injury following trauma. Suprapubic catheter requested.

Findings

CT images obtained after placement of suprapubic catheter show extravasation of contrast at the inferior posterior aspect of the bladder, tracking laterally through the pubic rami fracture, into the muscles of the proximal medial right thigh.

Diagnosis

Extraperitoneal traumatic bladder leak

Discussion

Traumatic bladder injuries are classified as intraperitoneal and extraperitoneal injuries. This patient had clinical evidence of traumatic injury, evidenced by blood through the penile meatus. In these cases, a retrograde uretherogram can be obtained to define the anatomy. Suspected bladder injuries should be evaluated by CT or conventional cystography. In this case, injection of contrast post-placement of a suprapubic catheter revealed the injury, likely at the uretheral origin, with an extraperitoneal bladder leak.

References

  1. Rackley R, Vasavada SP, Battino BS. Bladder trauma. Emedicine, June 15, 2006. http://emedicine.medscape.com/article/441124-overview

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