Case contributed by Liz Silverstone


Hepatitis, distended abdomen

Patient Data

Age: 70 years
Gender: Female

Bowel loops displaced medially by ascitic fluid lying between properitoneal fat line and colon. Inferior angles of liver and spleen obscured. Fluid attenuation superior to bladder.


Demonstrates ascites distribution along the paracolic gutters, around the inferior liver and spleen and in the paravesical fossae, separated from the bladder by a fat layer.

Case Discussion

Although radiographs are insensitive to ascites compared to cross-sectional imaging, large volume ascites is clearly recognisable as it obscures liver and spleen margins, displaces bowel and settles in the paravesical fossae appearing as ‘bladder ears’.

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