iothalamate-meglumine and Hematuria

We evaluated the importance of microscopic and gross hematuria and the role of retrograde cystography and computed tomography (CT) in the diagnosis of blunt traumatic bladder rupture.. All cases at a Level I trauma center between January 1, 1986, and March 31, 1989, were reviewed retrospectively.. Level I trauma center, university hospital.. All patients with acute blunt abdominal trauma admitted to this Level I trauma center.. The patients' charts were reviewed with emphasis on mode of diagnosis, treatment, and outcome.. Twenty-one patients had bladder rupture. All 21 had hematuria with more than 50 RBCs/high-power field, 17 gross and four microscopic. Twenty patients underwent retrograde cystography, which accurately identified bladder rupture, and one was found at laparotomy for other injuries. Seven patients had CT of the abdomen and pelvis, which failed to demonstrate bladder rupture. There were no associated urethral injuries in any of the patients with bladder rupture.. Significant (more than 50 RBCs/high-power field) hematuria is the principal indication for evaluation for blunt bladder injury, and retrograde cystography is the diagnostic procedure of choice. CT is neither sensitive nor specific enough as primary diagnostic modality.

Topics: Abdominal Injuries; Adolescent; Adult; Aged; Aged, 80 and over; Erythrocyte Count; Evaluation Studies as Topic; Female; Fractures, Bone; Hematuria; Humans; Injury Severity Score; Iothalamate Meglumine; Male; Middle Aged; Pelvic Bones; Pelvis; Retrospective Studies; Rupture; Tomography, X-Ray Computed; Urinary Bladder; Wounds, Nonpenetrating

A sufficient quantity of 30% w/v sterile barium sulfate suspension was infused into the caudal portions of urinary tracts of 12 young adult healthy male Beagles to induce vesicoureteral reflux. A control group of dogs was infused with a 7.5% solution of meglumine iothalamate. The dogs were radiographed at 1, 6, 13, and 29 days later. Three dogs from each group were euthanatized and necropsied (1 each) after radiography at each of these times. In some dogs, radiopacity in the prostate, urinary bladder, and renal pelvic diverticula due to barium persisted throughout the 30-day observation period. Opacity at or beyond 24 hours was not found in dogs infused with iothalamate. Light microscopy revealed barium either free or within macrophages in the submucosa of the bladder, in glandular and stromal areas of the prostate, and in the kidney. Renal barium was limited to pelvic diverticula (3 dogs), in a medullary tubule (1 dog), and in cortical tubules (2 dogs). Significant lesions attributable to barium were not seen in kidneys of dogs in the barium group. Iothalamate induced focal to multifocal inflammatory responses in some prostates; barium was phagocytosed by macrophages. Focal transient inflammatory and ulcerative lesions induced by bladder distention were observed in the bladder and urethral mucosa in both groups.

Topics: Animals; Barium Sulfate; Dog Diseases; Dogs; Hematuria; Iothalamate Meglumine; Male; Sterilization; Urogenital System; Urography; Urologic Diseases