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.
performed 10 days post-op did not demonstrate any extravasation or abnormal findings.
(5) Children, therefore require a voiding cystogram
, if VUR is to be detected.This procedure entails placement of a catheter, and may require sedation in a toddlers, it also carries a high risk of radiation exposure to gonads.
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.