Bladder diverticulum with huge calculus

Case contributed by Shailaja Muniraj

Presentation

Long standing urinary tract infection.

Patient Data

Age: 35 years
Gender: Male

There is a large well defined laminated radio-opaque focus note in the pelvic cavity.

Otherwise no significant abnormality seen.

ultrasound

There is a large hyperechoic focus noted within the bladder. The adjacent ureter is prominent. This focus also shows posterior acoustic shadowing.

There is a wide necked posterolateral outpouching of the urinary bladder wall near the left VUJ, in keeping with a bladder diverticulum. This diverticulum is well defined and shows a large sized calculus (1400 - 1600HU) within it. The calculus exerts mass effect on the bilateral VUJ with resultant moderate upstream hydroureteronephrosis.

The urinary bladder shows anterolateral wall thickening with internal debris, suggestive of cystitis.

Both kidneys demonstrate delayed excretion of contrast.

Mild kinking of the right upper ureter noted.

Special thanks: Dr. Madan Mohan Babu.

Case Discussion

Case of bladder diverticular calculus with resultant bilateral hydrouretronephrosis (due to mass effect on bilateral VUJ) and cystitis (due to stasis).

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