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2010-01-22-16 Answer to the case the week #268 © Manohar

Answer to the case of the week #268

May 20, 2010 - June 3, 2010


S. Manohar, MD, DMRD, M. Mohan Karthikeyan, MD, DMRD. 

Madurai, India.


This is a case of urethral atresia with the urinary bladder rupture diagnosed at the first ultrasound visit at 35 weeks of pregnancy.

The ultrasound examination described the following findings:

    • Severe oligohydramnios
    • Massive urinary ascites
    • Pyelectasis of the left kidney, normal right kidney
    • Ruptured bladder; discontinuation of the bladder wall at the fundal region with fluid leaking into peritoneal cavity
    • Male fetus with scrotal hydrocele

Images 1,2: Image 1 shows a fetal head, biparietal diameter corresponds with 35 weeks of gestation.  Image 2 shows a right kidney which is of a normal appearance and left kidney with pyelectasis. 


Images 3,4: Images show a massive ascites, urinary bladder with a visible discontinuation at the fundal region, indicated by arrow.


Images 5,6: Image 5 shows fetal scrotum with mild hydrocele. Image 6 shows a ascites and bladder ruptured at the fundal region, note arrow.


Images 7,8: Images show a ruptured bladder with a fluid leakage demonstrated by color Doppler.


Images 9,10: Image 9 shows a fetal bladder. Image 10 shows both umbilical arteries running along the bladder.



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