Clinics in diagnostic imaging (54)

A 29-year-old man sustained a pelvic fracture and haemorrhagic shock after a road traffic accident. He underwent an exploratory laparotomy open cystostomy, and iliac artery embolisation. Subsequent antegrade cystography and computed tomography showed a complete traumatic posterior urethral rupture with a "high riding" bladder. Delayed repair of the posterior urethra was performed 6 months later with good functional outcome. The risk of urethral injury in pelvic fractures, the mechanism of injury, and the role of imaging in the diagnosis of possible urethral injury in pelvic fractures are discussed.