What is extraperitoneal rupture of bladder?
Extraperitoneal rupture is the most common type of bladder injury (80%–90% of cases) (,12). It is usually caused by penetrating trauma; in blunt trauma, the presumed mechanism is direct laceration of the bladder by bone fragments from a pelvic fracture. The path of extravasated contrast material is variable.
What are symptoms of extraperitoneal bladder rupture?
In most cases, patients with bladder rupture have gross hematuria (77% to 100%). Other symptoms of bladder rupture include pelvic pain, lower abdominal pain, and difficulty voiding. It is important to note that trauma to the urinary tract is frequently associated with other traumatic injuries.
Which is the most accurate imaging modality for bladder injury?
CT cystography allows accurate diagnosis of the type of bladder rupture, including complex extraperitoneal and mixed intra- and extraperitoneal tears.
Is the bladder intraperitoneal or extraperitoneal?
In adults, the bladder is located in the anterior pelvis and is enveloped by extraperitoneal fat and connective tissue. It is separated from the pubic symphysis by an anterior prevesical space known as the space of Retzius.
Which part of bladder is Extraperitoneal?
Gross hematuria with normal cystography in the absence of upper tract injuries defines bladder contusion. Extraperitoneal injury is the most common bladder injury. Usually it is located at the bladder base. Extraperitoneal injuries can be managed conservatively with bladder drainage with a Foley catheter for 7–10 days.
How serious is a ruptured bladder?
1 Diagnosing a spontaneous urinary bladder rupture can be challenging, even with the aid of Computed Tomography (CT). If untreated, it can lead to severe complications such as sepsis, renal failure and hyperkalaemia, and can eventually cause death.
How long does it take a ruptured bladder to heal?
Extraperitoneal Rupture The urine and blood drain into a collection bag. It usually takes at least 10 days for the bladder to heal.
How is a retrograde Urethrogram performed?
You will lie on your back or side, and an x-ray of the urethra and bladder are taken. X-ray contrast agent (dye) is gently moved into your urethra. This may not be comfortable, but it doesn’t take long. More x-rays are taken with the dye to see your urethra more clearly.
How is a ruptured bladder diagnosed?
Various tests have been employed for diagnosis of bladder rupture, including ultrasonography [6], retrograde cystogram (RC) [1], and computed-tomography (CT) with [1,7] or without [5] cystography. Intraperitoneal BR (IBR) is commonly managed surgically; extraperitoneal (EBR) can be managed conservatively [8].
How is a retrograde cystogram performed?
During retrograde cystography, dye is injected into the bladder. X-rays are taken of the bladder while it’s filled with dye and again after the dye has drained. Retrograde cystography may show rupture of the bladder, as well as tumors, blood clots, or pouches in the wall of the bladder (diverticula).
What is Extraperitoneal?
The extraperitoneal space is the portion of the abdomen and pelvis which does not lie withinperitoneum. It includes: Retroperitoneal space, situated posteriorly to the peritoneum. Preperitoneal space, situated anteriorly to the peritoneum.
How long does a ruptured bladder take to heal?
Extraperitoneal Rupture But often it can be treated by simply placing a wide catheter into the bladder to keep it empty. The urine and blood drain into a collection bag. It usually takes at least 10 days for the bladder to heal.
How do they repair a ruptured bladder?
With an intraperitoneal injury, there are often other intraabdominal injuries; therefore, the bladder injury is repaired during laparotomy. It is repaired in a 2-layer fashion with absorbable suture. The bladder is then drained via a transurethral catheter or suprapubic catheter.
Can bladder rupture be fixed?
The injury can be repaired with surgery in most cases. The bladder may be drained by a catheter through the urethra or the abdominal wall (called a suprapubic tube) over a period of days to weeks. This will prevent urine from building up in the bladder.
What is a retrograde cystogram?
Retrograde cystography is a detailed x-ray of the bladder. Contrast dye is placed into the bladder through the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body.
Why is a retrograde urethrogram done?
A retrograde urethrography is a routine radiologic procedure (most typically in males) used to image the integrity of the urethra. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture. Urethrogram showing an urethra stricture in a man.
What is retrograde cystogram?
How is a retrograde cystogram used to diagnose bladder rupture?
A retrograde cystogram with bladder filling of 400 ml of radiopaque dye followed by a washout film will diagnose intraperitoneal and extraperitoneal ruptures of the bladder. False-negative cystograms occur with penetrating injuries of the bladder when only 250 ml or less of contrast medium is used to fill the bladder.
What is extraperitoneal rupture of the bladder?
Extraperitoneal rupture is the most common type of bladder injury, accounting for ~85% (range 80-90%) of cases. It is usually the result of pelvic fractures or penetrating trauma.
How is CT cystography performed in the workup of bladder rupture?
CT cystography is performed by instilling water-soluble contrast into the bladder through a Foley catheter. It may be combined with standard CT to evaluate the upper tracts. An extraluminal position of a urinary catheter indicates bladder rupture, although, in an underfilled bladder, the tip of the catheter may falsely appear extraluminal.
Is simultaneous bladder and posterior urethral rupture common in male patients?
Simultaneous bladder and posterior urethral rupture can occur in male patients, and the diagnosis of both ruptures is rarely m … Diagnostic studies in bladder rupture. Indications and techniques Urol Clin North Am. 1989 May;16(2):267-73. Author A S Cass 1 Affiliation