Case 73 - Cystic pelvic mass simulating the bladder
from Obstetrics and gynecology
Published online by Cambridge University Press: 05 March 2013
Edited by
Summary
Imaging description
A dominant pelvic cystic structure or fluid collection may be mistaken for the urinary bladder, as it can present with an identical appearance to the bladder on multiple images (Figure 73.1), on ultrasound, CT, or MRI. This apparent bladder is sometimes referred to as a “pseudobladder.”
Careful evaluation of the entire structure, and/or a high level of clinical suspicion leading to additional reformations or imaging, will usually help avoid this pitfall.
Importance
Mistaking a cystic structure for a distended urinary bladder can result in an erroneous diagnosis of bladder pathology, such as increased post-void residual secondary to bladder outlet obstruction [1]. This could result in inappropriate interventions such as Foley catheter or suprapubic catheter placement.
Moreover, a cystic mass mistaken for the urinary bladder can result in delayed identification of a pelvic cystic mass, such as a cystic ovarian carcinoma.
Typical clinical scenario
This potential pitfall arises when a large cystic mass is present in or near the pelvic midline, presenting with a similar or identical appearance to the bladder on many images. This may occur in studies performed specifically to evaluate the bladder, to evaluate for a pelvic mass, or for non-specific symptoms unrelated to the pelvis.
Information
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 246 - 247Publisher: Cambridge University PressPrint publication year: 2013
References
, , , . Cystic pelvic pathology presenting as falsely elevated post-void residual urine measured by portable ultrasound bladder scanning: report of 3 cases and review of the literature. Urology. 2000;55(4):590.CrossRefGoogle ScholarPubMed
, , , Pitfalls related to the urinary bladder in pelvic sonography: a review. Urol Radiol. 1983;5(4):253–9.CrossRefGoogle ScholarPubMed
, Fluid collections ultrasonically simulating urinary bladder. J Can Assoc Radiol. 1980;31(4):254–5.Google ScholarPubMed
, , , Large, septated ileal duplication cyst in a 4-year old, simulating the urinary bladder. Pediatr Surg Int. 1998;13(5–6):433–4.CrossRefGoogle Scholar
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