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Journal of Medical Ultrasonics

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1998 - Vol.25

Vol.25 No.02

Case Report(症例報告)

(0107 - 0112)

超音波検査にて診断し得なかった巨大膜胱憩室の1 例

A Case of Urinary Bladder Diverticula Not Diagnosed by Ultrasonography

尾崎 美紀1, 箱石 容子4, 藤田 幸二5, 中村 滋1, 岩崎 光博1, 西村 浩2, 安住 治彦2, 綛野 進3, 森本 義彦3, 朝井 均6

Miki OSAKI1, Yoko HAKOISHI4, Koji FUJITA5, Shigeru NAKAMURA1, Mitsuhiro IWASAKI1, Hiroshi NISHIMURA2, Haruhiko AZUMI2, Susumu KASENO3, Yoshihiko MORIMOTO3, Hitoshi ASAI6

1(医)寺西報恩会長吉総合病院臨床検査科, 2(医)寺西報恩会長吉総合病院内科, 3(医)寺西報恩会長吉総合病院外科, 4(医)相愛会相原第二病院臨床検査科, 5大阪鉄道病院中央検査室, 6大阪教育大学保健管理センター

1Department of Clinical Laboratory, Nagayoshi General Hospital, 2Department of Internal Medicine, Nagayoshi General Hospital, 3Department of Surgery, Nagayoshi General Hospital, 4Department of Clinical Laboratory, Aihara Dai Ni Hospital, 5Department of Clinical Laboratory, Osaka Railway Hospital, 6Health Administration Center, Osaka University of Education

キーワード : Huge cystic mass , Ultrasonography, Vesicle diverticula

We examined a 51-year-old man who did not complain of dysuria but did complain of abdominal distention and edema of the leg. Bulging extended from the epigastrium to the pelvic cavity. Initial ultrasonography showed a huge cystic mass containing several septum-like structures; bilateral hydronephrosis, ascites, and left pleural effusion were also present. Findings from computed tomography and magnetic resonance imaging were similar to those from ultrasonography, and none led to a correct diagnosis. Surgical removal of the cystic mass was planned under the diagnosis of an unknown abdominal mass. Surgery was called off, however, when the mass disappeared with the spontaneous excretion of about 2.51 of urine on urethral catheterization. Further examination showed the huge multilocular cystic mass to be a distended urinary bladder with three vesical diverticula. Urinary bladder diverticula can be cryptic and protean masses, sometimes assuming unexpected shapes and features that disguise their true identity. This shows that a diagnosis of bladder diverticula should be considered when a sonologist is confronted with a pelvic mass of ambiguous origin.