Cystogram may be unreliable in cases of gunshot wounds to the bladder: a case report.
BACKGROUND
Gunshot wounds to the bladder are not uncommon; however it is unusual that a bullet come to rest within the urinary bladder. Properly performed plain film cystography is trusted as a highly sensitive tool for identifying significant bladder injuries due to both blunt and penetrating trauma. Several reports suggest that cystography may be less sensitive in cases of gunshot wounds to the bladder.


METHODS
We report our recent experience with a gunshot wound to the bladder and review the use of cystography in the diagnosis of bladder injury in this setting.


RESULTS
Anecdotal case reports suggest that cystography may fail to identify gunshot injuries to the bladder. No large studies have been performed to evaluate its utility in this unique trauma circumstance.


CONCLUSIONS
Although reliable for the diagnosis of bladder perforation in most trauma settings, cystography may fail to diagnose a penetrating bladder injury due to a gunshot wound. High clinical suspicion based on bullet trajectory, history, and physical exam should guide the workup and treatment of such patients.
Kalorin
Carmin M
CM
Albany Medical Center in Albany, New York, USA.
Firoozi
Farzeen
F
De
Elise
E
Rosati
Carl
C
D000293:Adolescent; D003287:Contrast Media; D006801:Humans; D008297:Male; D011859:Radiography; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000293:injuries*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging* / Q000601:surgery
D003287:Contrast Media