Foreign body in urinary bladder--early CT cystogram is investigation of choice

Extra peritoneal bladder injuries are very difficult to diagnose on clinical examination alone. CT-scan with cystogram (Contrast: Ultavista300) is a reliable diagnostic tool to evaluate such injuries at an early stage. For accurate diagnosis of bladder injury, enhancement of bladder contents is necessary otherwise extravasated urine can be mistaken for haematoma or ascites. Retrograde filling of bladder with minimum 250 -300 ml of contrast material is necessary before performing abdominopelvic CT to rule out any form of bladder injury. Therefore in case of suspected bladder injury CT cystogram should be performed at the time of initial CT examination in the emergency room. We report a case of extraperitoneal bladder injury and foreign body in urinary bladder after a firework injury.