Traumatic bladder rupture with active extravasation visualized on point of care ultrasound

Abstract

Bladder rupture is a rare but serious consequence of blunt abdominal trauma, accounting for approximately 1.6 % of abdominal injuries, with increased incidence in the presence of pelvic fractures. Intraperitoneal bladder ruptures, most frequently occurring at the bladder dome, can lead to life-threatening complications if not promptly recognized and managed. This case report discusses an 18 year old female patient who was struck by a vehicle at high speed. Initial extended FAST (EFAST) not only revealed free fluid in the abdomen but revealed the site of bladder rupture and active extravasation on live ultrasound clip. This case highlights the diagnostic value of POCUS in detecting intraperitoneal bladder rupture in real-time, even in the absence of overt clinical signs or significant hematuria. It emphasizes the critical role of bedside ultrasound in facilitating early detection, accelerating clinical decision-making, and improving patient outcomes. The case reinforces POCUS as an essential tool for emergency medicine physicians.