Bladder Rupture after Blunt Trauma: Guidelines for Diagnostic Imaging

Abstract

The classic combination of pelvic fracture and gross hematuria constitutes an absolute indication for immediate cystography in blunt trauma victims. Existing data do not support lower urinary tract imaging in all patients with either pelvic fracture or hematuria alone. Clinical indicators of bladder rupture may be used to identify atypical patients at higher risk. Patients with isolated hematuria and no physical signs of lower urinary tract injury may be spared the morbidity, time, and expense of immediate cystographic evaluation.

Bladder Trauma: A 7 Year Review

“…The patients, who are operated for internal fixation of a pelvic fracture, require bladder repair to prevent urinary extravasation. This will prevent infection through foreign materials of internal fixation [13,14].…”

Management of urinary bladder injuries

“…3,4 They are usually associated with severe crushing trauma to the pelvic bone. Hence fracture of pelvic bones is a common accompaniment of extra peritoneal bladder injury.…”

“…The clinician needs to carry out investigations in a step wise fashion in order to rule out trauma to the various organs of the urinary system. 4 A patient presenting with blood at the meatus requires an ascending urethrogram to detect the presence of a urethral injury. Having ruled out a urethral injury one then needs to identify the cause for haematuria.…”

“…4,5 It is of utmost most importance to rule out major kidney injuries before studying the urinary bladder. This can be best done by CT imaging.…”

“…A CT cystogram or plain cystogram is diagnostic. 4 A CT scan can give an additional advantage of screening of concomitant other intra-abdominal injuries. However if this injuries are ruled out either clinically or radio logically then a plain cystogram can identify the nature of the bladder injury.…”