Rupture Bladder
| A | Celiotomy and open repair of the injury | |
| B |
Celiotomy and placement of drains in the retropubic space |
|
| C |
Insertion of a Foley catheter through the urethra |
|
| D |
Observation for evidence of a continuing urinary leak |
Following an automobile accident, a 20-year- old woman is found by a retrograde urethrogram to have an extraperitoneal bladder rupture. Initial management of this injury should be
| A |
Celiotomy and open repair of the injury |
|
| B |
Celiotomy and placement of drains in the retropubic space |
|
| C |
Insertion of a Foley catheter through the urethra |
|
| D |
Observation for evidence of a continuing urinary leak |
(C) Insertion of a Foley catheter through ……..
With Foley catheter drainage, an extra peritoneal bladder injury should close spontaneously. Colostomy and bladder repair is appropriate for intraperitoneal bladder injury. Suprapubic cystostomy may be required if a Foley catheter cannot be passed safely through an injury in the posterior urethra.
Which is the site for urine extravasation in extra peritoneal bladder rupture?
| A |
Prevesical region |
|
| B |
Groin |
|
| C |
Paracolic gutter |
|
| D |
None of the above |
The same is seen with bladder rupture and rupture of membranous urethra.
Extraperitoneal bladder rupture is almost always associated with pelvic fractures.
It is usually close to base of bladder anterolaterally. Subdivided into,
- Simple, with extravasation limited to perivesical space
- Complex, with extravasation extending to thigh, scrotum or perineum
Extraperitoneal bladder rupture is the most common type. Occurs in 80% of bladder rupture cases.
It is generally secondary to adjacent pelvic fracture or an avulsion tear at fixation points of puboprostatic ligaments.
Extraperitoneal bladder rupture can be treated conservatively.
Voiding cystourethrography historically been preferred contrast enhanced study for diagnosis of bladder rupture.
Most reliable investigation in bladder rupture is
| A |
IVP |
|
| B |
Cystoscopy |
|
| C |
Retrograde cystogram |
|
| D |
Catheterisation |
Ans. is ‘c’ i.e., Retrograde cystogram
