CT is a commonly ordered test for all types trauma to the pelvis. CT can let us look inside the pelvis for any injuries to the soft tissues structures such as the bladder as well as the bones. CT of the pelvis can tell us if there is something bleeding and needs to be treated urgently.
CT of the pelvis is often done to look for injuries to the bladder in the setting of trauma. The bladder will rupture and will have urine leak outside the bladder. CT done with contrast placed into the bladder is called a cystogram. In these cases, there will be contrast or dense fluid extending outside the bladder.
The bladder can rupture into the peritoneal cavity at the dome or upper part. This will allow urine to go into the peritoneum where the bowel and organs are. A bladder rupture in the lower part will be outside the peritoneal cavity into the tissues around the bladder.
The distinction is important because the injury needs to be surgicallly repaired when the bladder ruptures into the peritoneal cavity. Other injuries can be treated with a bladder catheter. Sometimes the bladder can rupture into both locations.
Other Soft Tissue Injuries Can be Seen
CT of the pelvis for trauma can also show us injuries to other soft tissues like bowel. We can also see blood from injuries to the abdominal organs. Fortunately, many CTs of the pelvis are done with CTs of the abdomen so that we can identify injuries to the organs.
CT for pelvic trauma can show us bleeds after trauma. This can be from injuries to blood vessels, organs, fractures, and muscle injuries. CT done after giving contrast through your vein can also show us active bleeding which needs to be treated urgently.
CT is also good at showing us the bones. CT after pelvic trauma can show fractures of the lower spine, pelvis, and hips. The CT can be reformatted especially for the bones to give us the most detail. Fractures of the bones may need urgent treatment and are occasionally associated with bleeds which need treatment.
CT of the pelvis after trauma is a great test for detecting all types of soft tissue and bony injuries which need treatment. The test is often done with CT of the abdomen to look for any organ or associated injuries. Sometimes reformations are done to look at the bones more carefully.