Purpose: Pelvic fracture evaluation with abdominopelvic computed tomography (CT) and formal CT cystography for rule out of urine bladder injury have been commonly employed in pediatric trauma patients. The additional ...Purpose: Pelvic fracture evaluation with abdominopelvic computed tomography (CT) and formal CT cystography for rule out of urine bladder injury have been commonly employed in pediatric trauma patients. The additional delayed imaging required to obtain optimal CT cystography is, however, associated with increased doses of ionizing radiation to pelvic organs and represent a significant risk in the pediatric population for future carcinogenic risk. We hypothesized that avoidance of routine CT cystography among pediatric pelvic fracture victims would not result in an appreciable rate of missed bladder injuries and would aid in mitigating the radiation exposure risk associated with these additional images.Methods: A retrospective cohort study involving blunt trauma pelvic fractures among pediatric trauma patients (age<14) between the years 1997 and 2016 was conducted utilizing the Israeli National Trauma Registry. Statistical analysis was performed using SAS statistical software version 9.4 via the tests of Chisquare test and two-sided Fisher’s exact test. Ap value of less than 0.05 was considered statistically significant.Results: A total of 1072 children were identified from the registry for inclusion. Mean age of patients was 7.7 years (range 0-14) and 713 (66.5%) were male. Overall mortality in this population was 4.1% (44/1072). Only 2.1% (23) of pediatric patients with pelvic fractures had bladder injury identified, with just 9 children having intraperitoneal bladder rupture (0.8% of all the patients).Conclusion: The vast majority of blunt pediatric trauma victims with pelvic fractures do not have urine bladder injuries. Based on our study results we do not recommend the routine utilization of CT cystography in this unique population.展开更多
Traumatic ruptures of the bladder are relatively rare lesions. They are associated in more than 80% of cases with a fracture of the pelvic girdle. The lesion mechanism is usually a sudden compression on the full bladd...Traumatic ruptures of the bladder are relatively rare lesions. They are associated in more than 80% of cases with a fracture of the pelvic girdle. The lesion mechanism is usually a sudden compression on the full bladder. Hypogastric pain and macroscopic hematuria suggest the diagnosis, which is confirmed by cystography. This diagnosis can be difficult and delayed in the absence of these call signs. We report a case of isolated traumatic intraperitoneal rupture of the bladder, diagnosed 24 hours after a public road accident in a 44-year-old patient.展开更多
文摘Purpose: Pelvic fracture evaluation with abdominopelvic computed tomography (CT) and formal CT cystography for rule out of urine bladder injury have been commonly employed in pediatric trauma patients. The additional delayed imaging required to obtain optimal CT cystography is, however, associated with increased doses of ionizing radiation to pelvic organs and represent a significant risk in the pediatric population for future carcinogenic risk. We hypothesized that avoidance of routine CT cystography among pediatric pelvic fracture victims would not result in an appreciable rate of missed bladder injuries and would aid in mitigating the radiation exposure risk associated with these additional images.Methods: A retrospective cohort study involving blunt trauma pelvic fractures among pediatric trauma patients (age<14) between the years 1997 and 2016 was conducted utilizing the Israeli National Trauma Registry. Statistical analysis was performed using SAS statistical software version 9.4 via the tests of Chisquare test and two-sided Fisher’s exact test. Ap value of less than 0.05 was considered statistically significant.Results: A total of 1072 children were identified from the registry for inclusion. Mean age of patients was 7.7 years (range 0-14) and 713 (66.5%) were male. Overall mortality in this population was 4.1% (44/1072). Only 2.1% (23) of pediatric patients with pelvic fractures had bladder injury identified, with just 9 children having intraperitoneal bladder rupture (0.8% of all the patients).Conclusion: The vast majority of blunt pediatric trauma victims with pelvic fractures do not have urine bladder injuries. Based on our study results we do not recommend the routine utilization of CT cystography in this unique population.
文摘Traumatic ruptures of the bladder are relatively rare lesions. They are associated in more than 80% of cases with a fracture of the pelvic girdle. The lesion mechanism is usually a sudden compression on the full bladder. Hypogastric pain and macroscopic hematuria suggest the diagnosis, which is confirmed by cystography. This diagnosis can be difficult and delayed in the absence of these call signs. We report a case of isolated traumatic intraperitoneal rupture of the bladder, diagnosed 24 hours after a public road accident in a 44-year-old patient.
