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Spaghetti sign (bladder)

Last revised by Assoc Prof Frank Gaillard on 25 Apr 2019

The spaghetti sign may be seen in upper urinary tract bleeding.

It refers to the presence of a linear worm- or spaghetti-like filling defect within a contrast-opacified bladder 1,2. This linear filling defect represents blood clot extruded from the ureter and thereby molded into a tubular shape 1,2. It is seen in patients with gross hematuria 1,2. Presence of this sign is an indication of upper urinary tract bleeding 1,2. The finding can be appreciated on intravenous urogram, retrograde pyelography, and CT in the excretory phase 1,2.

History and etymology

This sign was first described in 1981 by Funsho Komolafe, a Nigerian radiologist working at the University College Hospital, Ibadan at the time 1.

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