75-year-old male found in an accident in the street, with craniocerebral trauma, fractures to the right upper and lower extremities and ribs, with intense subcutaneous emphysema, and mild haematuria. He was admitted to the Intensive Care Unit for ventilatory support and imaging studies of the pelvis revealed a closed fracture of the pelvic bones with bone splinters impinging on the bladder. A reconstruction of the CT images appeared to rule out penetrating bladder injury. However, once vital signs were stabilised, cystoscopy was performed and showed perforation of the anterior bladder wall by the bone splinter. The bladder was repaired by a suprapubic approach and the bone fragment was removed, with no sequelae and subsequent good healing of the fractures.

