Diagnostic Odyssey of CT Cystography in Unravelling Traumatic Bladder Injuries

To evaluate the efficacy of CT cystography (CTC) in detecting bladder injuries following blunt pelvic trauma.

A case series. Place and Duration of the Study: Department of Radiology, Lahore General Hospital, Lahore, Pakistan, from October 2023 to March 2024.

Sixty patients were enrolled who fulfilled the inclusion criteria, i.e., patients presented with bladder injuries following blunt pelvic trauma. Exclusion criteria were patients with confirmed isolated posterior urethral injury, a history of procedures involving the peritoneal cavity, such as exploration laparotomies for diagnostic peritoneal lavage, or abdominal surgery. An initial evaluation was done, followed by CTC. Experienced radiologists reviewed the images. Then, a cystoscopy was performed in the Urology Department. All the data were recorded on a pro forma. A 2 x 2 table was used to calculate and analyse the results.

A total of 60 patients were included. Among them, 43 (71.7%) were male, and 17 (28.3%) were female, with an age range of 25-60 years. The mean age (SD) was 42.86 ± 9.10 years. Out of 60 patients, 52 (86.7%) were diagnosed with a urinary bladder rupture through cystoscopy, while 43 (71.7%) were identified via CTC. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and accuracy of CTC were 80.7%, 87.5%, 97.6%, 41.1%, and 81.6%, respectively.

CTC is a valuable diagnostic modality in identifying traumatic bladder injury. For the entire course of treatment and prognosis, prompt identification of these injuries may be essential.

Contrast-enhanced computed tomography, Bladder injuries, Blunt pelvic trauma, Cystoscopy, CT cystography, Traumatic bladder injuries.