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Trauma Urogenital

Trauma to the urogenital tract can occur through both blunt and penetrating mechanisms. Blunt trauma can cause minor injuries like bruising or contusions as well as more severe injuries involving tearing of the renal cortex, medulla, or blood vessels. Penetrating trauma accounts for 15-40% of bladder injuries and can be iatrogenic from procedures like biopsy. Imaging like cystography, CT, and ultrasound are used to evaluate for injuries and extravasation of contrast. Blunt trauma can lead to extraperitoneal or intraperitoneal rupture of the bladder. Findings on imaging include tear drop signs, extravasation of contrast, or defects in the bladder wall. Prompt surgical repair may be needed for severe injuries.

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98 views17 pages

Trauma Urogenital

Trauma to the urogenital tract can occur through both blunt and penetrating mechanisms. Blunt trauma can cause minor injuries like bruising or contusions as well as more severe injuries involving tearing of the renal cortex, medulla, or blood vessels. Penetrating trauma accounts for 15-40% of bladder injuries and can be iatrogenic from procedures like biopsy. Imaging like cystography, CT, and ultrasound are used to evaluate for injuries and extravasation of contrast. Blunt trauma can lead to extraperitoneal or intraperitoneal rupture of the bladder. Findings on imaging include tear drop signs, extravasation of contrast, or defects in the bladder wall. Prompt surgical repair may be needed for severe injuries.

Uploaded by

janette
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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TRAUMA UROGENITAL

JA N E T TE HUT UBESSY – 4 2 1 80284


K E PA NITER AAN K L I N I K BAG I A N R A DI OLOGI
FA KULTAS KE DOK T ERA N U N I V ERSITAS K R I STEN DU TA WACA N A
Trauma Urogenital
TRAKTUS URINARIUS
Anatomi Traktus Urinarius
◦ Ginjal
◦ Ureter
◦ Vesica Urinaria
◦ Uretra
Vesica Urinaria
Normal dapat menampung 500 – 1500 mL urine
Drainase kendung kemih bermuara ke vena iliaca interna

Back
Mekanisme Trauma
Trauma tumpul -> penyebab trauma
 Langsung : KLL, Olah raga, Kecelakaan kerja, Perkelahian
 Tidak Langsung :
 Jatuh dari ketinggian  menyebabkan pergerakan ginjal tiba-tiba dlm rongga retro
peritonium Avulsi pedikel ginjal  Robekan tunika intima
 Trauma iatrogenic
 Pengambilan biopsi ginjal
 Infeksi tidak langsun
 Pemasangan kateter di atas ureter
 Cedera Ginjal
• Minor
• Mayor
• Vaskuler
Mekanisme Trauma
•Cedera Minor
• 90% trauma ginjal
• Kontusio ginjal
• Laserasi parenkim superficial
• Cedera Mayor
• Laserasi korteks, medula tanpa ekstravasasi
• Laserasi korteks, medula dengan ekstravasasi
• Cedera Vaskuler
• Avulsi
• Trombosis
GAMBARAN RADIOLOGI
Pemeriksaan Radiologi
TRAUMA VESIKA URINARIA
Disebabkan : Trauma
◦ Tumpul
◦ Tajam
◦ Iatrogenik
Didaerah pelvis / abdomen bawah/perineum
60-85 %  trauma tumpul
15-40 %  trauma tajam
Ruptur vesika urinaria :
•Ekstra peritoneum
◦ Intra peritoneum
◦ Keduanya

Kontusio Vesika Urinaria


Sobekan sebagian mkosa vesika urinaria
Dinding  memar  hematom

Pemeriksaan :
Sistografi
CT scan abdomen - pelvis
Kontusio Vesika Urinaria
 Normal
 Tear Drop
 Mudah sembuh

Ruptur Vesika Urinaria


Terlihat ekstravasasi kontras
- ekstra peritonial
- intra peritonial
Dengan CT Scan  dpt juga mengevaluasi organ lain
Pear shaped appearance
Persistent pain in the left lower abdomen for 5 days after bladder biopsy by
transurethral resection. CT scan
Motor vehicle accident.
Intra-peritoneal bladder rupture was subsequently proven at laparotomy.
Sagittal sonography of the urinary bladder shows a wall defect at the dome and
intraperitoneal free fluid.
Case Discussion
This patient complained of severe
abdominal pain after being kicked in
his lower abdomen and also presented
with gross hematuria and an inability
to urinate.
Ultrasound obtained one hour after
the trauma, demonstrates gross free
fluid in the pelvis and a disruption of
the urinary bladder wall.
He received immediate surgery, where
a disruption of 7 cm was found in the
dome of the urinary bladder. The
patient has also a history of a previous
bladder rupture five years earlier as a
result of a road accident.
TERIMA KASIH
GOD BLESS YOU !

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