4/29/12
CT cystography
CT cystography
The degree of wall injury Anatomic location Demonstrated characteristic imaging features for each type of injury
4/29/12
CT cystography
CT cystography with retrograde bladder distention(150-300cc) replacing radiography Diagnostic accuracy approaching 100% CT scan with intravenous administrated contrast is not feasible because of increased scan time to 30min for delay scans 50 mL of Hypaque 60 [Nycomed, Princeton,NJ] and 450 mL of normal saline solution
Postdrainage images through the decompressed bladder are not 4/29/12 required
CT cystography
CT
1. 2. 3.
Known pelvic fractures Gross hematuria Severe pelvic trauma with no known pelvic fractures
4/29/12
Classification
4/29/12
Type 2 and 5 need surgery Type 1 and 3 manage conservatively Type 4 manage conservatively if urine clear of blood,cathater function well and blader neck is not injured.otherwise surgery is prefered.
4/29/12
Type 1
Findings
4/29/12
Type 2
10%20% Direct
blow to the already distended bladder contrast material Around bowel loops, Between mesenteric folds, In the paracolic gutters.
Intraperitoneal 1. 2. 3.
4/29/12
4/29/12
Type 2
4/29/12
Type 3
An
intramural
4/29/12
Type 3
4/29/12
Type 4
Usually
In
blunt trauma, the presumed mechanism is direct laceration of the bladder by bone fragments from a pelvic fracture is confined to
a.Simple:Extravasation
Type 4a
4/29/12
Type 4b
4/29/12
Type 4b
4/29/12
Type 5
Combined
patterns
of injury
4/29/12
Type 5
4/29/12
4/29/12
NO,its type 4b
Contrast
material is seen in the properitoneal space (extraperitoneal subserous tissue) of the right lower quadrant. should not be confused with intraperitoneal contrast material.
This
4/29/12
Type 4b
4/29/12
question?
4/29/12
4/29/12