Case 74
Clinical Presentation
A 28-year-old man ran into a door while exiting a bar, and the door knob struck his suprapubic region.
Imaging Findings
A cystogram image shows the urinary bladder (arrow) to be nearly empty. Contrast is seen in the peritoneal cavity (asterisk) outlining the bowel loops (arrowheads). No obvious pelvic fracture is present.
Differential Diagnosis
• Intraperitoneal urinary bladder rupture: Contrast within the peritoneal cavity is a hallmark of intraperitoneal urinary bladder rupture.
• Combined-type urinary bladder rupture: Although there is contrast in the peritoneal cavity, there is no extraperitoneal contrast.
• Extraperitoneal urinary bladder rupture: This is the more common type of urinary bladder rupture. However, the presence of intraperitoneal contrast with no streaky extraperitoneal contrast makes it unlikely.
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