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False negative retrograde cystography with bladder rupture owing to external trauma
The Journal of Trauma
|February 1, 1984
Summary
Retrograde cystograms can miss bladder ruptures. Using 400 ml contrast and a post-washout film significantly reduces false negatives in trauma cases, improving diagnostic accuracy for bladder injuries.
Area of Science:
- Radiology
- Urology
- Trauma Imaging
Background:
- Bladder rupture diagnosis relies on imaging.
- Retrograde cystography is a common diagnostic tool.
- External trauma is a frequent cause of bladder rupture.
Observation:
- Five false negative retrograde cystograms occurred in 116 trauma-related bladder ruptures.
- Low contrast volume (≤250 ml) and absence of a post-washout film were identified as contributing factors.
Findings:
- Increasing contrast volume to 400 ml and including a post-washout film eliminated false negative results.
- Optimized retrograde cystography protocols enhance detection of bladder ruptures.
Implications:
- Standardizing retrograde cystography technique is crucial for accurate bladder rupture diagnosis.
- Improved imaging protocols can prevent missed diagnoses and ensure timely patient management.
- This study highlights key technical adjustments for better trauma imaging outcomes.