Following blunt pelvic trauma, CT cystography is performed after retrograde filling of the bladder with dilute contrast. Contrast extravasates into the perivesical space and tracks along the fascial planes of the anterior abdominal wall and into the scrotum, but no contrast is seen around bowel loops or in the paracolic gutters. Which type of bladder injury is this?

• A Extraperitoneal rupture ✓
• B Intraperitoneal rupture
• C Interstitial bladder injury
• D Urethral transection

Explanation

Extraperitoneal bladder rupture, usually associated with pelvic ring fractures, leaks contrast into the perivesical extraperitoneal spaces, producing a flame shaped collection confined by the peritoneal reflection, with tracking along fascial planes into the thigh, scrotum or anterior abdominal wall. Intraperitoneal rupture, typically from a blow to a full bladder, spills contrast freely around bowel loops, into the paracolic gutters and pouch of Douglas. Interstitial injury shows submucosal contrast without frank extravasation.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.