Presentation
Pelvic trauma.
Patient Data
CT cystography shows extravasation of contrast to the right anteroinferior aspect of the bladder, with contrast tracking through the pubic diastasis into the scrotum and along the pelvic sidewalls, and medial compartment of the left thigh as well as lower abdominal subcutaneous ragion. A small amount of contrast is also extravasated intraperitoneally in the left para-colic gutter.
Left-sided sacral ala and right-sided pubic rami fractures are seen.
Case Discussion
Extraperitoneal bladder rupture with contrast extravasating into the pelvic sidewalls, lower rectus sheath, scrotum, and left thigh. Intraperitoneal extravasation was also noted at the left paracolic gutter.
Bladder rupture can be intraperitoneal (treated with surgery) or extraperitoneal (treated with indwelling urinary catheter (IDC)) or both.