Bladder rupture is an uncommon and severe condition usually associated with abdominal or pelvic trauma but can also occur spontaneously. A study from 2001 to 2011 showed that only 56 of 15,168 abdominal trauma patients who presented to the emergency department (ED) were diagnosed with a bladder rupture. Extraperitoneal bladder rupture was found in 22 and intraperitoneal bladder rupture in 27 patients. In 5 cases, the bladder rupture was combined. 11% of all the patients had a lethal outcome. (Matlock, Kinzie A et al., 2013). Most of the time, extraperitoneal ruptures are also present with pelvic bone fractures. Due to the high mortality rate, an urgent recognition of bladder rupture is essential to decrease the chances of lethal outcomes. Extraperitoneal ruptures are usually managed conservatively, while intraperitoneal ruptures require immediate surgical repair. (Guttmann I, Kerr...

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A retrospective study was performed in the Hospital of Lithuanian University of Health Sciences Kauno Klinikos (LUHS Kauno Klinikos) Radiology department from September 2021 to February 2022. Six patients (ages 30 to 65 years old, median age of 26 years old) were enrolled. Inclusion criteria included clinically or radiologically proven bladder rupture. The study was performed by reviewing the clinical cases of each patient. The issues were sorted into 3 groups depending on whether a bladder rupture was of extraperitoneal, intraperitoneal, or combined type. Clinical presentation was summarized into four main symptoms: anuria before catheterisation, haematuria, abdominal distention, and abdominal pain. Various radiological imaging techniques were analysed, including computed tomography (CT), CT cystography, and ultrasound (US) of the abdominal region. The cases were examined for changes...

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Non-specific abdominal pain localized around the hypogastric area, distention, and haematuria upon catheterisation were observed in all cases. Three patients also experienced a period of anuria before catheterisation.

The US of the abdomen was performed for 5 patients (83.4%), and in 3 cases (50%) non-specific bladder debris was observed.

CT scan was performed in all cases, and CT cystography for 3 patients (50%). In the cases of intraperitoneal bladder rupture, dome lesion and per intestinal contrast accumulation was observed. In the cases of extraperitoneal rupture, the contrast extravasation in peri vesical and retropubic space as well as around sacroiliac joints, was observed.

Extraperitoneal, intraperitoneal, and combined bladder rupture occurred in 2...

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Bladder rupture often presents with non-specific clinical symptoms, which results in missed or delayed diagnosis. It is essential to differentiate between intraperitoneal and extraperitoneal bladder ruptures, as the treatment strategy varies greatly. CT scan is the gold standard for bladder rupture diagnosis.