Comparison of computed tomography and conventional cystography for detection of traumatic bladder rupture

Computed tomography (CT) is the method of choice for evaluating patients with blunt abdominal and/or pelvic trauma. However, the sensitivity of CT for detecting bladder ruptures has been questioned. We reviewed both the conventional cystograms and the CT examinations of 25 patients who had both studies as the initial evaluation of blunt abdominal and pelvic trauma in the last 5 years. Five of these 25 patients had bladder ruptures, three extraperitoneal and two intraperitoneal. All five injuries were detected by both CT and conventional cystography. In one patient the conventional cystogram was falsely positive. In this case the correct diagnosis was made by CT, and a repeat cystogram confirmed that no bladder injury was present. Our results indicate that CT, if properly performed, is as sensitive for detection of bladder injuries as conventional cystography.