Tag Archives: Bladder

Bilateral hydronephrosis with a stone in the urinary bladder

In the first image, you can see bilateral severe hydronephrosis as evidenced by the dilated collecting system filled with anechoic (black) urine exerting pressure on the renal parenchyma. Second image shows bladder ultrasound with echogenic debris and a stone appearing as hyperechoic curved structure with a shadow. The echogenic material could be a blood clot also. Usually but not always, debris moves with moving the patient while clot remains adherent to the bladder wall. On color Doppler, Stones demonstrate twinkling, which is a rapidly alternating focus of intense color signals resembling turbulent flow that is more pronounced with rougher stones. Don’t forget to scan urinary bladder in any patient with hydronephrosis, even if they have a Foley catheter.

Urinary bladder diverticula – The Mickey Mouse sign

A bladder diverticulum is a sac that protrudes out of the bladder wall. Diverticulae may be congenital or acquired and acquired diverticula from chronic bladder outlet obstruction are commonly encountered in adults. They appear as Mickey Mouse ears on bladder ultrasound, with the bladder representing the head.

Here is an example of a large bladder diverticulum. Much larger than a typical Mickey Mouse ear!

Here is another large bladder diverticulum, courtesy of Dr. Robert Jones. The bladder is not empty despite the presence of Foley because the clip was obtained immediately after placing it.