A 44 y.o. male presents to an outside ED with penile pain and forceful urination that “sprays” per EMS.

The CT is shown below and was read as "mild stranding suggestive of pyelo"   What was missed by the teleradiologist?

The urethra is very dilated suggesting a stricture

The urethra is very dilated suggesting a stricture

The pt initially had  2+ LE , 3+ blood and WBC of 23K. he was treated with rocephin , diagnosed as mild pyelo and elected to be treated at home with cipro. He returned in 7 days with the CT showing the image below. 

What happened?

urethra, rupture with nec.JPG