Julia R. Fielding, M.D. Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts

Motor Vehicle Accident Victim with Gross Hematuria

This 36 year-old woman was involved in a motor vehicle accident but fortunately was restrained by a seat-belt. On arrival at the emergency room, she was hemodynamically stable and a contrast-enhanced CT scan was performed.

The diagnosis was intraperitoneal bladder rupture. Free contrast is seen just anterior to the bladder (Figure 1). A large amount of low density urine surrounds the liver (Figure 2) and there is a minimally displaced fracture of the sacrum (Figure 3). The patient was taken to the operating room for exploration and a large 3 cm rupture of the bladder dome was repaired.