Bladder Rupture

Bladder ruptures may be classified as extraperitoneal, intraperitoneal, or both.

Extraperitoneal rupture usually involves the anterolateral bladder wall. 90% of cases are associated with a fracture of the anterior ring of the pelvis. The classic appearance on cystography has been described as "flame-shaped," referring to the jagged irregular margins of the extraperitoneal contrast. Contrast may spill into the perineum, scrotum, or thigh if there is rupture of the urogenital diaphragm.

Inraperitoneal rupture typically involves a horizontal tear along the dome of the bladder. On cystography, the peritoneal organs are outlined by contrast and there is a homogeneous, cloud-like appearance to the contrast. Pelvic fractures are associated with 75% of inraperitoneal ruptures.

References

Zagoria RJ and Tung GA (1997). Chapter 6. in Genitourinary Radiology: The Requisites.