An otherwise healthy, 30-year-old man is brought to the emergency department after being thrown off the back of a motorcycle. During the assessment, blood is noted at the urethral meatus. Which of the following statement is TRUE?
Initially, advanced trauma life support (ATLS) protocol requires that airway, breathing, and circulation (ABC) to be maintained. Blood at the urethral meatus is an indication of lower urinary tract (bladder, urethra, penis) injury. Foley catheter should not be inserted until the integrity of urethra is assessed (usually by performing a retrograde urethrogram). Trauma x-ray panel includes a pelvic study to evaluate the extent of injury to pelvic brim and pubic symphysis. Fracture of the pubic rami or diastasis of pubic symphysis are commonly associated with dislocation of the sacroiliac joint as well as direct or indirect injury to the bladder and bulbous urethra.
A foley catheter should be inserted immediately.
Dislocation of the sacroiliac joint is usually associated with a fracture of the pubic ramus or separation of the symphysis.
Open lavage is a useful indication for the need to perform laparotomy.
Fracture of the coccyx requires surgical excision in most patients.
Urethra & Penis