Not every anechoic thing in the pelvis is urine!

In this pelvic area sonogram, the Foley balloon (arrow) appears to be located outside the urinary bladder suggesting malposition of the catheter. However, the fluid collection anterior to the Foley is pelvic ascites and the Foley is in appropriate position as shown by the green dot in the illustration. Blood, serous fluid, and urine are all black on ultrasound. Note the margins of this ‘bladder-like’ structure are irregular which should make us suspect something isn’t right. To confirm the diagnosis, we should perform a long axis scan which will show that this fluid collection is in continuity with the peritoneal cavity. Moreover, a patient’s medical history should alert to the presence of pelvic ascites. It’s interesting to note that the bedside bladder scanning devices that are available in most hospitals these days can wrongly display ascitic fluid volume as bladder volume in this scenario.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: