The Role of Computerized Tomography in the Diagnosis of Bladder Rapture

ABSTRACT

BACKGROUND: Computerized topography(CT) is the method of choice for establishing patients with abdominal and/or pelvic trauma. However, the sensitivity of CT far detecting bladder rupture has been questioned. We investigated the roles of CT as the initial evaluation of abdominal and pelvic trauma in diagnosis of bladder rupture. METHODS: We reviewed the medical records and radiographs of 53 patients with bladder rupture for last 5 year. And among them, all radiographs of 30 patients who underwent both CT and retrograde cystography were evaluated independently by two urologists who had no knowledge of the patients' final diagnosis. RESULTS: Among 30 patients, all of patients were correctly diagnosed by retrograde cystography, but the CT diagnosis was correct in only 23 patients(76.7%), who were 17 patients(85.0%) with intraperitoneal rupture and 6 patients(60%) with extraperitoneal rupture. And of the 7 patients who were negative by the CT, all showed the sign of inadequate bladder distension. CONCLUSION: We suggest that CT, if properly performed with adequate bladder filling, is as sensitive for detection of bladder injuries as conventional cystography. Especially, in trauma patients with hematuria and suspected other organ injury, CT-cystography with retrograde filing may be as accurate as conventional cystography and obviate the need for an additional plain film cystography,