Bladder Rupture (extraperitoneal)

Bladder injuries occur in 10% of patients with pelvic fx

Two types of ruptures: extraperitoneal (45%) and intraperitoneal (45%). Combined are 10%

Radiographic evaluation in supected bladder injury:
- Retrograde urethrogram. Should precede cystogram is suspicion of urethral injury
- Cystogram
- CT Cystogram. Retrograde bladder distention is required before CT cystography. At least 350 ml contrasted fluid required. Get continguous images throughout bladder. Obtain postdrainage images through the decompressed bladder

Classification of Bladder Injury:
- Type 1: Bladder contusion
- Type 2: Intraperitoneal rupture
- Type 3:Interstitial bladder injury
- Type 4:Extraperitoneal rupture
- Type 4a:Simple extraperitoneal rupture
- Type 4b:Complex extraperitoneal rupture
- Type 5:Combined bladder injury

Source: http://www.healthimaginghub.com/learning-center/radiology-teaching-files/2010/08/15/81-bladder-rupture-extraperitoneal.html