Author: Abbas Tayyab Syed / Editor: Stephen Sheridan, Sarah Edwards / Codes: / Published: 08/05/2026
A 25-year-old man presents to the Emergency Department (ED) with lower abdominal pain and an inability to pass urine since the previous evening. He reports slipping on the road the day before and striking her lower abdomen against the corner of a footpath. He states that initially he experienced only mild discomfort and did not seek medical attention. Over several hours, he developed worsening suprapubic pain, abdominal distension, and a strong urge to void without success.
He reports no visible haematuria or external bruising and has no significant past medical history.
On examination, he appears uncomfortable but haemodynamically stable. His abdomen is mildly distended with suprapubic tenderness but no guarding or bruising. A bedside bladder scan shows minimal urine volume, inconsistent with his sensation of retention. A FAST scan (shown below) demonstrates free intraperitoneal fluid.
