- 7 year old mn Puggle presented for hematuria seen at the end of micturition.
- Urinlalysis showed hematuria, proteinuria, USG=1.044, no bacteria seen.
- Urinary tract ultrasound shows a diffusely thickened bladder wall with irregular mucosa, shadowing, gravity-dependent echogenic sediment (or small stones), and swirling intraluminal content. Echogenic foci are also present throughout the bladder lumen.
- 1mg/kg furosemide was given IV to futher distend the bladder lumen but had minimal effect after 15 minutes.
- 7 year old mn Puggle presented for hematuria seen at the end of micturition.
- Urinlalysis showed hematuria, proteinuria, USG=1.044, no bacteria seen.
- Urinary tract ultrasound shows a diffusely thickened bladder wall with irregular mucosa, shadowing, gravity-dependent echogenic sediment (or small stones), and swirling intraluminal content. Echogenic foci are also present throughout the bladder lumen.
- 1mg/kg furosemide was given IV to futher distend the bladder lumen but had minimal effect after 15 minutes.
- It is difficult to determine what is bladder wall and what is intraluminal content. Color flow Doppler was not that helpful as the patient’s increased respiratory rate created too much movement.
- My primary differential is chronic cystitis with concurrent bladder sand or small stones. Any grounds for emerging neoplasia here?
- I am also wondering about the intraluminal echogenic foci…mineralization? blood clot? gas?
