A 75-year-old male who was found to be an accident in the street, with head and brain trauma, fractures in the right upper and lower extremities and ribs, with intense subcutaneous emphysema, and mild hematuria.
She was admitted to the Intensive Care Unit for ventilatory support and pelvic imaging studies showed a closed fracture of the pelvic bone with pelvic floor impronment in the intensive bladder.
A CT image reconstruction seemed to rule out penetrating bladder injury.
However, once vital signs are present, cystoscopy is performed showing a perforation of the anterior bladder wall by the bone schirl.
The bladder was repaired through supra-pituitary access and the bone fragment was removed without sequelae and with subsequent good healing of the fractures.
