bladder rupture

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Posted on 12/06/2009

 A 65 year old female with osteoporosis presents to the ED after a high speed MVC: restrained passenger with airbag deployment. Unable to ambulate at scene complaining of severe pelvic and lower abdominal pain. She was diagnosed with an unstable pelvic fracture on x-rays. She remained persistently tachycardic despite pain control and fluid resuscitation. She subsequently developed a fever. Upon examination of the urine you notice gross blood. A Foley catheter is inserted into the urethra and an x-ray retrograde urethrogram is negative. The catheter is then inserted into the bladder and the following study it performed. What is your diagnosis?

bladder extrav.jpg