Bladder Trauma

Question 1

what is this usually caused by?

Answer 1

pelvic fracture

Question 2

presentation

Answer 2

suprapubic/ abdominal pain
inability to void
bruising, guarding, reduced sounds

Question 3

diagnosis

Answer 3

CT cystography

retrograde urethrogram

Question 4

diagnosis of extra-peritoneal injury

Answer 4

flame-shaped collection of contrast in pelvis

Question 5

management

Answer 5

large bore catheter and antibiotics

Question 6

indications for immediate repair

Answer 6

intraperitoneal injury, penetrating injury, inadequate drainage or clots in urine, bladder neck injury, rectal or vaginal injury, open pelvic fracture, pelvic fracture requiring open reduction/fixation, patients undergoing laparotomy for other reasons and bone fragments projecting into bladder

Question 7

what is the risk in fracture of pubic rami?

Answer 7

urethral injury

Question 8

presentation of urethral injury

Answer 8

blood at meatus
inability to urinate
full bladder
high riding prostate
butterfly perineal haematoma

Question 9

diagnosis of urethral injury

Answer 9

retrograde urethrogram

Question 10

management of urethral injury

Answer 10

suprapubic catheter
delayed reconstruction (3 months)