Document Detail

CT diagnosis and localization of rupture of the bladder in children with blunt abdominal trauma: significance of contrast material extravasation in the pelvis.
MedLine Citation:
PMID:  7717239     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to determine the utility of CT performed with maximal bladder distension in showing extravasation of IV contrast material as a means of detecting and localizing bladder rupture in children after blunt trauma. MATERIALS AND METHODS: Seven of 1500 consecutive children who had IV contrast-enhanced CT of the abdomen after blunt trauma had a rupture of the bladder proved at surgery (five patients) or by clinical and imaging findings (two patients). The scanning protocol in all patients included occlusion of the Foley catheter if present and a 5-min delay after IV injection of contrast material prior to scanning the pelvis. The CT scans of all 1500 children were prospectively evaluated for the presence and location of extravasated contrast material in the pelvis. RESULTS: Extravasated IV contrast material in the pelvis was noted in all seven children with bladder rupture (intraperitoneal in four, extraperitoneal in three) and two of 1493 children without bladder rupture (extraperitoneal in both). Both children with contrast material extravasation who did not have bladder rupture had a renal injury. The location of the rupture (intraperitoneal or extraperitoneal) could be determined from the distribution of extravasated contrast material in the pelvis seen on CT scans. CONCLUSION: The use of a scanning delay at CT prior to imaging the pelvis showed extravasation of IV contrast material in all seven children with bladder rupture. Intraperitoneal and extraperitoneal bladder rupture could be differentiated on the basis of the distribution of extravasated contrast material seen on CT scans.
C J Sivit; J P Cutting; M R Eichelberger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  164     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-05-18     Completed Date:  1995-05-18     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1243-6     Citation Subset:  AIM; IM    
Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC 20010, USA.
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MeSH Terms
Abdominal Injuries / radiography*
Child, Preschool
Extravasation of Diagnostic and Therapeutic Materials / radiography*
Kidney / injuries
Prospective Studies
Tomography, X-Ray Computed*
Urinary Bladder / injuries*
Wounds, Nonpenetrating / radiography*

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