Major Bladder Trauma: The Accuracy of Cystography

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Abstract
Cases (51) of traumatic bladder rupture were studied. Extravasation was noted in 32 cases for which retrograde cystograms were available, including 3 (9%) in which additional infusion of contrast medium was required to demonstrate extravasation. Of the 32 cystograms 4 (13%) showed rupture on the drainage film only. If drainage films and adequate bladder distension with contrast medium had been omitted the diagnostic accuracy of the cystogram would have been reduced to 79%. If strict attention is paid to adequate bladder distension with contrast material and to obtaining drainage films, diagnostic retrograde cystography for trauma should be almost totally accurate and delays or errors in diagnosis should be rare.