The case reported here is presented because of the absolute yet unique manner in which a diagnosis of ruptured bladder was made, in spite of negative Vaughan-Rudnick air cystograms.
Miss J. S., aged 24, was brought to the Berwyn Hospital on the evening of April 3, 1929, after the automobile in which she was riding had been struck and overturned by a Rapid Transit car. After a few hours of rest the moderate shock of the patient subsided, and she complained of suprapubic distress. A roentgenogram of the pelvis showed fractures of both rami of the right and left pubes. On catheterization, 150 cc. of bloody urine was obtained.
Three hundred cc. of air was injected into the bladder, but air cystograms and fluoroscopic studies by the Vaughan-Rudnick method1 were not abnormal. Two hours later, distinct crepitation could be felt beneath the skin in the suprapubic area from the
Stephens VR, Vynalek WJ. A NEW DIAGNOSTIC AID IN SUSPECTED EXTRAPERITONEAL BLADDER RUPTURE. JAMA. 1929;92(22):1833–1834. doi:10.1001/jama.1929.92700480002010b
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