Bladder flap haematoma

Bladder flap haematoma is a haematoma between the uterus and posterior wall of bladder. They may be small (more commonly) or large (>5 cm, less common).

Small hematomas may be asymptomatic. Large ones may present with lower abdominal pain, dysuria, anaemia and fever (if infected).

It is an uncommon complication of cesarean section, due to bleeding and uterine dehiscence, usually at transverse lower uterine incision. It has also been reported with longitudinal incisions.

Ultrasound

It is seen as heterogenous solid lesion with variable amount of fluid component. Presence of air foci strongly suggests infected hematoma or an abscess. It is less useful in demonstrating the dehiscence.

MRI

It has the ability to distinguish the blood products (see: ageing blood on MRI) and abscess. Sagital and axial images have been very useful in demonstrating transverse lower uterine and longitudinal incisional dehiscence respectively.

CT

May show slightly hyper-attenuating fluid density in between posterior wall of bladder and uterus, however, MRI is preferred over CT.

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Article Information

rID: 31569
System: Obstetrics
Tag: cases
Synonyms or Alternate Spellings:
  • Bladder flap haematomas
  • Bladder flap hematoma
  • Bladder flap hematomas

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