The Bladder is an Important Organ

[Ronald Gross]

Ceasar,

I usually divide these folks into blunt no pelvic fracture and blunt with fracture, and further divide them into those with and without gross hematuria (and this latter group I do not screen).  The pelvic fx and gross hematuria patients all get cyctograms -and a retrograde cystourethrogram prior to that in the male.  The blunt with no fx but hematuria get a cysto alone.  I am old fashioned, and choose to do a hand held RUG followed by the regular cysto with 400-450 cc's on conray AND a post void/emptying film as well.

Ron

>>> "caesar ursic" <cmursic at gmail.com> 2/1/2008 2:01 PM >>>
(FYI:  January is Bladder Health and Injury Prevention Month.)

Two question for the group:

1. When do you specifically screen for bladder injuries in your
polytraumatized (blunt) patients?


2. How do you do it?
A. CT scan.  Do you clamp the urinary catheter first?  Do you instill
contrast into the bladder prior to scanning?
B. Retrograde cystogram (i.e. instilling contrast via the bladder catheter
and shooting plain films)?
C. Other?

Many Thanks, etc.

C Ursic, MD
Santa Fe, USA
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