On CT cystography following blunt pelvic trauma, contrast instilled through a Foley catheter extravasates into the perivesical space and tracks into the scrotum and anterior abdominal wall, but no contrast is seen around bowel loops. What is the diagnosis?

• A Intraperitoneal bladder rupture
• B Bladder contusion
• C Posterior urethral injury
• D Extraperitoneal bladder rupture ✓

Explanation

Extraperitoneal rupture, usually from pelvic fracture fragments lacerating the bladder base, shows contrast confined to the perivesical space with the characteristic molar tooth pattern tracking along fascial planes to scrotum and abdominal wall. Intraperitoneal rupture, typically from a full bladder struck by a seat belt, shows contrast outlining bowel loops and the paracolic gutters, which is absent here.

Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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