Abstract
This is a unique case of bladder injury from a penetrating upper leg wound. The patient's initial presentation did not suggest genitourinary injury, however the patient had a relatively late episode of gross hematuria that prompted further investigation. Based on findings of bladder laceration, the patient was managed conservatively and did well. To our knowledge an injury with this particular trajectory and mechanism has not been described previously in the literature. It stands as a reminder that genitourinary trauma can have many points of origin and that a high index of suspicion is necessary during evaluation of these patients.