Case of the Month: September, 2011, Page 3

Answer: B. Extraperitoneal bladder rupture

An additional image reveals the point of contrast extravasation in the left anterior bladder wall.

Diagnosis: Traumatic pelvic fractures with associated extraperitoneal bladder rupture.

Key points

Extraperitoneal bladder rupture leads to extravasation into the space of Retzius
- Accounts for 62% of bladder injuries, most common type
- Usually due to pelvic fractures
Intraperitoneal bladder rupture typically occurs at the dome of the bladder
- Accounts for 25% of bladder injuries, more common in children
- Due to direct blow to abdomen with a distended bladder
Treatment options
- Antibiotics and catheter drainage
- Surgical repair
- Follow-up cystography in 10 days after either conservative or surgical treatment