[Traumatic bladder perforation in pelvic ring fracture. Case report with differential diagnostic aspects]

In the context to multiple traumata, a 19-year-old man suffered an extraperitoneal bladder rupture due to perforation by a fractured pubic ramus. Because of a rapid shock-induced decrease of hematuria and the misinterpretation of a bruise on the right flank as a renal contusion, the clinical diagnosis was not established. The patient died of head injuries and ruptures of the liver and diaphragm with hemothorax and intra-abdominal bleeding. The impressive bladder perforation was first documented at the postmortem examination. The diagnosis and differential diagnosis of hematuria are discussed.