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Urinary bladder hematoma

Case contributed by Servet Kahveci
Diagnosis almost certain

Presentation

Dysuria and hematuria. On anticoagulant therapy.

Patient Data

Age: 70 years
Gender: Male
ultrasound

A heterogeneous hypoechoic lesion is seen inside the bladder in keeping with a bladder hematoma.

Annotated image

Bladder hematoma (yellow arrow).

Hyperechogenic area refers to active hemorrhage (red arrow).

Normal urine (white arrow).

ct

Hyperdense content relative to the fluid density of urine is seen within the bladder. Given the clinical context, it is in keeping with a hematoma. A hyperdense area in the posterior region of the bladder is suggestive of active hemorrhage. 

ANNOTATED IMAGE

Annotated image

The bladder hematoma (yellow arrows) appears slightly hyperdense compared to normal urine (white arrow) and includes a hyperdense area referring to active hemorrhage (red arrow).

Case Discussion

Although ultrasonography and CT can both demonstrate bladder hematomas, the former appears superior to the latter due to the limited ability to differentiate isodense hematomas on CT. The cause of bleeding was attributed to the patient's anticoagulant therapy.

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