Overlooked Bladder Pathologies in Transabdominal Ultrasound Examinations

Kelsey Watt, Richard Chaytor, Catherine Gutteridge, Peter Cantin, Imaging University Hospitals Plymouth NHS Trust


Transabdominal ultrasound examinations are a routine investigation in the management of surgical patients with acute abdominal or pelvic pain. The bladder is often imaged purely to measure residual urine volumes or used as a window for interrogation of the ovaries and uterus. However, there are a range of important pathologies that may be overlooked unless the bladder is specifically examined as an organ itself.


This retrospective pictorial review of patients presenting with acute abdominal pain or urinary symptoms in a tertiary centre demonstrates the range of bladder pathologies that may be missed during transabdominal ultrasound examinations. 


This imaging review includes a range of bladder pathologies that were encountered during transabdominal ultrasound urinary tract examinations, including urachal cysts, ureteroceles, emphysematous cystitis, fistulae, calculi and a range of tumors.  We also review best practice for ultrasound examination of the bladder, to minimise the risk of false negative examinations.


Ultrasound evaluation of the bladder should not be dismissed as purely for assessing residual urine volumes or as a ‘window’ for examination of the pelvis. Instead, dedicated examination of the bladder is required during ultrasound evaluation of the urinary tract or during routine trans-abdominal ultrasound examinations.  Those undertaking ultrasound in patients with abdominal-pelvic pain or urinary symptoms should possess an understanding of potential bladder pathologies in order to accurately diagnose them and expedite management.

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