Abdominal and Pelvic Trauma
9.10-year-old boy with abdominal and pelvic trauma. VCUG = Voiding cystourethrography: Visible are the bladder and the urethra. At the transition from the prostatic to the membranous urethra an extravasation of contrast is visible.
The diagnosis is partial rupture of the urethra.
Depending on the type of urethral lesion blood is visible at the external urethral orifice.
In addition, hematuria or erythrocytes in the urine sediment, and/or urinary retention may be present in spite of strangury.
Although severe trauma to the urethra and bladder is a relatively rare differential diagnosis of hematuria in childhood, in case of polytrauma, pelvic fractures, and traces of trauma on the external genitals and perineum, such a trauma must always be considered.
As additional examination a retrograde urethrography with fluoroscopy is indicated;
in this case the catheter was introduced too far in the direction of the bladder.
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