[Pneumoperitoneum in bladder rupture]

Pneumoperitoneum is rarely seen with bladder rupture. In blunt abdominal trauma this sign is strongly suggestive of gastric or bowel perforation. In our child, suspicion of bladder trauma was evoked by car belt marks in the hypogastrium and by gross hematuria. Preoperative diagnosis was not confirmed because immediate surgical exploration was required based on the presence of free air in the abdominal roentgenograph.