* VCUG
o Voiding cystourethrography historically been preferred contrast enhanced
study for diagnosis of bladder rupture
o Bladder needs to be fully distended and evaluation of a post-voiding
film essential
* Plain film:
o "Pear-shaped" bladder
o Paralytic ileus
o Upward displacement of ileal loops
o Flame-shaped contrast extravasation into perivesical fat
+ Best seen on postvoid films
+ May extend into thigh / anterior abdominal wall
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhK3wi1fU8NZwpT47ljqQFHL5-QBQWavDbuBalpz13QGUWBipclNEnTtpxyOdZhSKEwnvcr6anj_QOR02ThANz73VHMqSFX2WZRBUFMzN9baCV5MeOv-70WmKbLaJM5soLAY6MQTb_5CZM/s400/cow101.jpg)
right lateral wall of bladder representing extra-peritoneal contrast from a bladder rupture
* US
o "Bladder within a bladder" = bladder surrounded by fluid collect