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Extraperitoneal bladder injury with extensive contrast extravasation - A case report
Haven Ward1, Muhammad Nazim2, Ruiyang Jiang3
1Department of Medical Education School of Medicine, Texas Tech University Health Sciences Center, Physical Address 6040 Belpree Rd Apt#H294, Amarillo, TX, 79107, USA.
Urology Case Reports
|May 9, 2022
Summary
Conservative management with Foley catheter drainage effectively treats traumatic extraperitoneal bladder ruptures, even with severe contrast extravasation. This approach led to successful healing in a patient who fell from a horse.
Area of Science:
- Urology
- Trauma Surgery
- Radiology
Background:
- Extraperitoneal bladder ruptures are common, comprising 70-90% of all bladder injuries.
- Conservative management, including Foley or suprapubic catheter drainage, is standard for uncomplicated cases.
- The degree of contrast extravasation on cystogram often does not dictate treatment strategy.
Observation:
- A 59-year-old male experienced a traumatic extraperitoneal bladder rupture after a fall from a horse.
- The patient presented with significant contrast extravasation into the extraperitoneal space.
- Conservative management was selected as the primary treatment approach.
Findings:
- The patient's bladder rupture was successfully managed conservatively.
- Prolonged Foley catheter decompression facilitated the healing of the bladder injury.
- Severe contrast extravasation did not preclude successful non-operative treatment.
Implications:
- This case highlights the efficacy of conservative management for severe extraperitoneal bladder ruptures.
- Foley catheter drainage can be a definitive treatment, even in complex presentations.
- Non-operative management should be strongly considered for traumatic bladder injuries with significant extravasation.
