Overlooked Bladder Pathologies in Transabdominal Ultrasound Examinations
Kelsey Watt, Richard Chaytor, Catherine Gutteridge, Peter Cantin, Imaging University Hospitals Plymouth NHS Trust
Background:
Transabdominal ultrasound examinations are a routine investigation in the management of surgical patients with acute abdominal or pelvic pain. The bladder is often imaged purely to measure residual urine volumes or used as a window for interrogation of the ovaries and uterus. However, there are a range of important pathologies that may be overlooked unless the bladder is specifically examined as an organ itself.
Methods:
This retrospective pictorial review of patients presenting with acute abdominal pain or urinary symptoms in a tertiary centre demonstrates the range of bladder pathologies that may be missed during transabdominal ultrasound examinations.
Results:
This imaging review includes a range of bladder pathologies that were encountered during transabdominal ultrasound urinary tract examinations, including urachal cysts, ureteroceles, emphysematous cystitis, fistulae, calculi and a range of tumors. We also review best practice for ultrasound examination of the bladder, to minimise the risk of false negative examinations.
Conclusion:
Ultrasound evaluation of the bladder should not be dismissed as purely for assessing residual urine volumes or as a ‘window’ for examination of the pelvis. Instead, dedicated examination of the bladder is required during ultrasound evaluation of the urinary tract or during routine trans-abdominal ultrasound examinations. Those undertaking ultrasound in patients with abdominal-pelvic pain or urinary symptoms should possess an understanding of potential bladder pathologies in order to accurately diagnose them and expedite management.