Extraperitoneal bladder rupture without pelvic fracture due to high-impact blunt trauma: the report of two cases

Blunt trauma of the abdomen may cause rupture of the bladder especially when the bladder is distended. It is shown that 70–97% of patients with bladder rupture from trauma have associated pelvic fractures, and retrograde cystogram is the gold standard for the diagnosis.In this report, we present two cases of extraperitoneal Type IV bladder rupture diagnosed with retrograde CT cystography with urethral contrast. Contrary to the literature, in both cases, nopelvic fractures were present despite high-energy impactions. Epidural and subdural hematomas in both cases certify the high-energy of the impact these patients exposed. Both cases were managed with simple catheterization and drainage.We think that retrograde CT cystography is an indispensable diagnostic tool for blunt pelvic trauma patients since bladder injuries may occur without pelvic fractures. Absence of meatal blood or pelvic fractures may not necessarily rule-out the presence of bladder injuries