Isolated Ascites on CT After Blunt Trauma: A Sign of Intraperitoneal Bladder Rupture

We report a case of intraperitoneal bladder rupture in a 24-year-old man who was struck by a motorcycle. Initial contrast-enhanced CT scan shortly after presentation to our emergency department demonstrated simple free fluid within the upper abdomen and pelvis. Delayed CT scan of the pelvis showed contrast extravasation into the perineal cavity. CT cystography showed rupture of the bladder dome with active contrast extravasation. This case illustrates that intraperitoneal bladder rupture should be considered as an etiology for otherwise unexplained ascites after blunt abdominal trauma. Delayed CT and CT cystography should be considered for further evaluation.