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British Journal of Radiology (2006) 79, e1-e4
© 2006 British Institute of Radiology
doi: 10.1259/bjr/96369737
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Pyourachus: study of two cases

R B Thapar, DMRD, DMRE 1 V U Jha, MS 2 R U Mehta, MD 1 and G R Shah, MS, MCh 2

Departments of 1 Radiology and 2 Urology, Sir Hurkisondas Nurrotamdas Hospital & Research Center, Raja RamMohan Roy Road, Mumba-400004, India


Figure 1
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  		Figure 1. Ultrasound of the pelvis showing a well localized hypoechoic collection indenting the bladder dome.

 

Figure 2
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  		Figure 2. (a) Contrast enhanced CT (CECT) scan at the level of bladder dome showing a thick walled, rim enhancing collection related to the anterosuperior aspect of the bladder. Note the relatively high density of the collection as compared with the urine in the bladder, suggestive of infected turbid contents. (b) CECT scan at the level of the umbilicus shows the heterogeneously enhancing collection with adjacent fat stranding extending up to the umbilicus.

 

Figure 3
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  		Figure 3. Sagittal multiplanar reconstruction(MPR) image delineates the classical "cone-shaped" anatomical extent of the collection along the course of the urachus with its tip at the umbilicus and the base over the bladder dome.

 

Figure 4
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  		Figure 4. Intraoperative photograph showing the infected urachus being excised en bloc.

 

Figure 5
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  		Figure 5. Contrast enhanced CT scan at the level of the bladder shows a focal, heterogeneously enhancing, nodular lesion along the anterosuperior aspect of the bladder.

 

Figure 6
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  		Figure 6. Cystoscopy showing an indentation on the bladder dome with petechial haemorrhages in the overlying mucosa.

 




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