Imaging findings in Bladder Rupture

-Diagnostic evaluation of bladder rupture includes voiding cystourethrography (VCUG) or CT scan

* VCUG
o Voiding cystourethrography historically been preferred contrast enhanced
study for diagnosis of bladder rupture
o Bladder needs to be fully distended and evaluation of a post-voiding
film essential
* Plain film:
o "Pear-shaped" bladder
o Paralytic ileus
o Upward displacement of ileal loops
o Flame-shaped contrast extravasation into perivesical fat
+ Best seen on postvoid films
+ May extend into thigh / anterior abdominal wall

One image from an IVU shows a flame-shaped density adjacent to

right lateral wall of bladder representing extra-peritoneal contrast from a bladder rupture

* US
o "Bladder within a bladder" = bladder surrounded by fluid collection