Bladder Diverticulum





KEY FACTS


Terminology





  • Saccular outpouching from herniation of bladder mucosa and submucosa through muscular wall of bladder



Imaging





  • Most commonly near ureterovesical junction



  • Anechoic outpouching from bladder with narrow or wide neck, may empty with micturition



  • CT/MR: Fluid attenuation outpouching from bladder



  • Usually fills with contrast on excretory postcontrast phase



Top Differential Diagnoses





  • Urachus



  • Everted ureterocele



  • Paraovarian cysts in female



  • Pelvic cysts in male



Pathology





  • Acquired: Most common secondary to chronic bladder outlet obstruction (60%)



  • Congenital: Hutch diverticulum (40%)



  • Vesicoureteral reflux



Clinical Issues





  • Narrow-neck diverticula: Urinary stasis → complications such as infection, stone, and ureteral obstruction



  • Secondary inflammation predisposes to development of carcinoma within diverticulum



  • Complications




    • Carcinoma



    • Vesicoureteral reflux



    • Ureteral obstruction




Scanning Tips





  • Look for debris, calculi, or solid masses in diverticula, which can indicate complication



  • Color Doppler may show jet to and from diverticulum to bladder; do not mistake for ureteral jet







Graphic shows a diverticulum arising from the lateral bladder wall, due to herniation of the mucosa and submucosa through the muscular wall.








Transabdominal transverse oblique ultrasound of the urinary bladder shows 2 left posterolateral diverticula with narrow necks . One of the diverticula shows a urinary jet as Doppler signal into the diverticulum .

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Nov 10, 2024 | Posted by in ULTRASONOGRAPHY | Comments Off on Bladder Diverticulum

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