title: [Extraperitoneal bladder rupture coinciding with bone fragments: the case for surgical treatment].
abstract: BACKGROUND
  In closed traumatic bladder ruptures, a surgical treatment of the intraperitoneal rupture, and a conservative approach to the extraperitoneal one, with bladder catheter, antibiotics and confirmation of bladder wound closure after two to three weeks-, was recommended. Only recently, attention was paid to the importance of the presence of bone fragments of the pelvic fractures, that in the vecinity of a bladder catheter or urinary infection may give raise to either severe pelvic infection or permanent urinary fistula.
  
  
  METHODS
  The two cases of extraperitoneal bladder rupture here presented, demonstrate the difficulties of a secure diagnosis by CT, and the potential severity of the existence of bone fragments impronting the bladder disruption.
  
  
  CONCLUSIONS
  Recent consensus on genitourinary trauma emphasizes the need to pay attention to the presence of bone fragments of the pelvic ring fractures in cases of closed bladder rupture. In cases of extraperitoneal bladder rupture with bone fragments in the vecinity, bladder endoscopic examination and surgical treatment may be needed.
authors: Servicio de Urología, Hospital POVISA, Vigo, Pontevedra, España. luisfarina@yahoo.com
authors: Luis A
authors: LA
authors: Fariña Pérez
authors: Daniel
authors: D
authors: Pesqueira Santiago
authors: Pedro
authors: P
authors: Posadilla Casquete
authors: Carmen
authors: C
authors: Trinidad López
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D012421:Rupture; D001743:Urinary Bladder / Q000293:injuries* / Q000601:surgery*