Imaging findings in bladder injuries.

Congress:

ECR 2019

Poster Number:

C-2413

Type:

Educational Exhibit

Keywords:

Surgery, Diagnostic procedure, Cystography / Uretrography, CT, Urinary Tract / Bladder, Trauma, Abdomen, Acute, Education and training

Authors:

P. Concejo Iglesias, J. Cubero Carralero, C. Ferreiro Arguelles, W. A. Ocampo Toro, J. H. Álvarez Cuenca, D. F. Blanco García, M. A. Hoyas García; Leganés (Madrid)/ES

DOI:

10.26044/ecr2019/C-2413

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-2413

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Learning objectives

To review the anatomic spaces surrounding the bladder. To describe the various types of bladder injuries and discuss their mechanisms. To describe the best CT protocol and the imaging clues to identify a bladder rupture.

Background

Despite the fact that bladder injuries are rare, imaging plays an important role since appropriate management lead to reduced morbidity and mortality. They can be categorized as traumatic - blunt or penetrating- and spontaneous. Bladder injuries are an uncommon entity. It can occur spontaneously [1] after blunt trauma, which represents 85% of cases, penetrating trauma or iatrogenic [1, 2]. The susceptibility to bladder injury is related to the degree of distension of the bladder [3, 4]. The most frequent type is extraperitoneal which management is...

Findings and procedure details

The radiologist should be familiarized with anatomical spaces and structures in order to make a good approach to bladder injuries (Fig 1, 2, 3, 4, 5 and 6). There are several classifications for bladder injuries. We have chosen those which we consider more useful. Classifications: Bladder injuries are usually classified by AAS scale [6] based on surgical findings: - Type 1: bladder contusion. - Type 2: extraperitoneal laceration <2 cm. - Type 3: extraperitoneal laceration > 2 cm and intraperitoneal laceration <2 cm. - Type...

Conclusion

Despite the fact that bladder injuries are rare, the radiologist should be familiarized with CT findings since imaging plays a critical role both in diagnosing these injuries and indetermining the management.

Personal information

References

1. Gross, J. S., Rotenberg, S., & Horrow, M. M. (2014). Resident and Fellow Education Feature Bladder Injury: Types, Mechanisms, and Diagnostic Imaging. RadioGraphics, 34(3), 802-803. 2. Voelzke, B., & Richie, J. P. Traumatic and iatrogenic bladder injury. 3. Vaccaro, J. P., & Brody, J. M. (2000). CT cystography in the evaluation of major bladder trauma. Radiographics, 20(5), 1373-1381. 4. Sandler, C. M., Francis, I. R., & Baumgarten, D. A. (2007). Suspected lower urinary tract trauma. ACR appropriateness criteria, 1-10. 5. Chan, D. P., Abujudeh,...