Presentation
Motor vehicle accident.
Patient Data
There is a moderate amount of free fluid within the right upper quadrant and right paracolic gutter, with a small amount of fluid also seen in the left upper quadrant and the mesentery. This fluid is only slightly denser than water / urine, but certainly does not represent merely a hemoperitoneum. The dome of the bladder appear a little thickened and irregular, although the bladder is well distended.
There is no liver injury demonstrated. The spleen, pancreas or adrenal glands and kidneys are normal in appearance. No bowel wall thickening appreciated. Duodenum unremarkable. No lumbar spinal or pelvic fractures. Minor subcutaneous fat stranding in lower anterior abdominal wall, in keeping with seatbelt injury.
Case Discussion
Intra-peritoneal bladder rupture was subsequently proven at laparotomy.