The mother noticed the pencil pushed in a few centimeters from the anal opening so she removed it and the child settled down. On examination the child looked very well. No urine was seen coming from that opening. The urinary catheter was left in place for seven days and the patient was put on oral antibiotics. Micturating cystourethrogram was done 14 days later and showed no further evidence of extravasation.
Discussion Penetrating urinary bladder injuries in childhood are very rare.
This was a genuine though unfortunate accident. Extravasation of dye seen in later films. Splinter in the urine. Inadvertent puncture of the urinary bladder by peritoneal dialysis catheter.