Pear shaped bladder
Post traumatic haematoma
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AP view from a cystogram showing a pear shaped bladder.  Right superior pubic ramus fracture
The contrast filled bladder is becoming distorted in shape, with comression of the lateral walls leading to an apparent increase in the inferosuperior dimension of the bladder, or the so-called pear shaped bladder appearance. The right superior pubic ramus is fractured, explaining the increase in pelvic fluid (hemorrhage) that would give this appearance to the bladder.