Bladder incarceration within a displaced pelvic ring nonunion

Abstract

Pelvic ring injuries can be challenging to manage and may have a range of associated injuries. When bladder injuries occur in combination with pelvic ring fractures, a multidisciplinary approach may be required to plan the best course of treatment. Acute entrapment or injury to the urinary bladder after a pelvic fracture is well reported. Here, we present an interesting case of chronic bladder incarceration within a lateral compression pelvic ring injury nonunion after failed nonoperative management of the initial pelvis fracture. Treatment of the nonunion was complicated by an incidental diagnosis of lymphoma.

Unrecognised entrapment of a herniated bladder at the pubic symphysis following reduction and external fixation of an unstable pelvic fracture

“…A superior alternative would be a flexible cystoscope given its ability to examine with a retrograde view. A pelvic CT remains the most accurate diagnostic tool for bladder entrapment given its ability to delineate anatomical relationships in three dimensions 7 9–11. As demonstrated here, a post pelvic reduction CT is important in identifying an entrapped bladder.…”

“…Diagnosis of bladder entrapment can pose varying diagnostic challenges and can sometimes be identified on initial trauma CT or cystogram 9. However, instances of delayed diagnosis have been described when patients present with persistent lower urinary tract symptoms 7 10. If left unrecognised, an incarcerated bladder is liable to become ischaemic and result in urine extravasation, which will lead to poor functional outcomes and delayed healing of any concurrent injury.…”