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Case of the Week 589



What is the most likely diagnosis?

  • 56 year-old in motor vehicle collision; pelvic radiograph after injection of contrast into bladder



Frontal Radiograph of Pelvis
After Contrast Injected into Bladder

  1. Colovesical Fistula
  2. Extrophy of the Bladder
  3. Intraperitoneal Bladder Rupture
  4. Bladder Tumor
  5. Extraperitoneal Bladder Rupture

Additional image - None

 

 

Additional Images

 


None


Answer:

 

3. Intraperitoneal Bladder Rupture

 

More (Click Discussion Tab)

 

 

Intraperitoneal Bladder Rupture

 

General Considerations

  • Can be secondary to traumatic or iatrogenic injury
  • Five types of rupture
    • Type I: Bladder contusion
      • Most common form
      • Results from incomplete tear of bladder mucosa
      • Cystography is normal
    • Type II: Intraperitoneal rupture
      • Results from trauma to lower abdomen when bladder is distended
      • Because bladder dome is weakest portion, it ruptures most easily
      • Contrast is then seen in the paracolic gutters and between loops of small bowel

MORE . . .

 


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