Bladder injury in blunt pelvic trauma.

Abstract

Clinical and radiologic findings in 97 patients with bladder injury secondary to blunt pelvic trauma were reviewed. Fifty-five patients had extraperitoneal bladder rupture; 35, intraperitoneal rupture; two, interstitial bladder injury; and five, combined intraperitoneal and extraperitoneal bladder rupture. Of the 61 of 97 patients with film studies available for review, two patients with surgically proved intraperitoneal rupture had false-negative cystograms. In two other cases of intraperitoneal rupture, the diagnosis was established with cystography but was not demonstrated with urography. All cases of extraperitoneal rupture were demonstrated cystographically; in 15 cases in this group, the injury was complex, with extravasation of contrast material beyond the confines of the perivesical space. In two additional patients, incomplete bladder injury termed "interstitial bladder rupture" was identified. A classification of bladder injury based on cystographic patterns of extravasation is proposed.

Delayed presentation of traumatic intraperitoneal bladder rupture

“…Hematuria, dysuria, and urinary retention all commonly occur with bladder injury, but are not specific for rupture [2]. Pelvic fractures, although often present with intraperitoneal bladder rupture, may be absent as in our case.…”

“…Intraperitoneal bladder rupture may occur when the bladder is distended and blunt trauma to the pelvis or lower abdomen produces a sudden rise in intravesical pressure [2]. Rupture usually occurs at the weakest point of the bladder wall, the posterior dome of the bladder.…”

“…Rupture usually occurs at the weakest point of the bladder wall, the posterior dome of the bladder. Although there is controversy on the relative incidence of intraperitoneal versus extraperitoneal rupture in adults, intraperitoneal rupture occurs most often in children [1,2]. This has been attributed to a more abdominal location of the bladder during childhood [3].…”

“…Intraperitoneal rupture occurs most often in children in contrast to adults in whom extraperitoneal rupture results with equal or greater frequency [1,2]. Usually the diagnosis of bladder rupture is readily established and prompt treatment instituted.…”

Simultaneous bladder rupture with obstetrics anal sphincter injury following forceps application: a case report and review of literature

“…7 Sandler et al has described five types of bladder injuries with conventional cystography such as simple bladder contusion, intra peritoneal rupture, interstitial bladder injury, extra peritoneal bladder rupture and combination of intra and extra peritoneal bladder rupture. 8 Intra peritoneal bladder injury results due to sudden increase in pressure within the distended bladder due to external force/pressure. It demonstrates extra luminal contrast extravasation to intra peritoneal cavity within bowel loops in cystography.…”