Imaging modalities such as CT and
cystograms should be considered pre-operatively to clearly delineate the anatomy if there is suspicion for bladder involvement, as well as to guide surgical repair.
Browder et al., "Prospective evaluation of the utility of routine postoperative
cystogram after traumatic bladder injury," Journal of Trauma and Acute Care Surgery, vol.
CT scan chest/abdomen and
cystogram confirmed a bladder perforation and intra-abdominal fluid extravasation as illustrated in Figure 2.
Catheter was removed after three weeks and
cystogram was done to exclude the failure of surgery.
Post operatively, the ruptured bladder can be managed safely with simple catheter drainage and leave the catheter in for 7-10 days and then obtain a
cystogram (Kotkin and Koch, 1995).
A CT
cystogram was performed which demonstrated vesicoureteral reflux into the collecting system and incarceration of dilated ureter within a right inguinal hernia.
Voiding
cystogram performed 10 days post-op did not demonstrate any extravasation or abnormal findings.
Minor isolated extraperitoneal bladder injuries were managed nonoperatively with catheter drainage alone, prophylactic antibiotics, and a
cystogram on the 10th to 14th day.
A voiding
cystogram revealed an elongated 'teardrop' bladder with constant indentation and irregularity of the vesical dome suggestive of extrinsic compression with possible mural invasion (Fig.
However, in group C,
cystogram showed almost normal shape of urinary bladder.