A patient with a pelvic fracture develops haematuria. On CT cystogram, extravasation of contrast is seen within the peritoneal cavity. The most appropriate management is:
- A Surgical exploration and primary bladder repair ✓
- B Urethral catheterisation and conservative management
- C Suprapubic catheter insertion alone
- D Embolisation of pelvic vessels
Correct answer: A. Surgical exploration and primary bladder repair
Explanation
Intraperitoneal bladder rupture (contrast extravasation within the peritoneal cavity on CT cystogram) requires urgent surgical repair, as urine in the peritoneum causes chemical peritonitis and sepsis. Extra-peritoneal bladder ruptures, which are more common in pelvic fractures, can be managed conservatively with catheter drainage. Embolisation is used for arterial pelvic bleeding causing haemodynamic instability, not for bladder rupture.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.