Limitations of routine spiral computerized tomography in the evaluation ofbladder trauma

Purpose: We evaluate the accuracy of spiral computerized tomography (CT) in diagnosing traumatic bladder rupture. Materials and Methods: Medical records of 24 consecutive patients diagnosed with traumatic bladder rupture at our level 1 trauma center from 1993 to 1 998 were retrospectively reviewed. Of the patients 15 underwent retrograde cystography and spiral CT of the abdomen and pelvis. The results of these i maging studies were compared. Results: Retrograde cystography successfully diagnosed all cases of bladder rupture and correctly classified injuries confirmed surgically. Spiral CT successfully diagnosed 9 of 15 bladder ruptures (60%), and correctly classi fied 4 of 5 intraperitoneal (80%) and 6 of 11 extraperitoneal (55%) rupture s. Conclusions: Spiral CT is less accurate than retrograde cystography in diag nosing traumatic bladder rupture.