pear-shaped bladder

Pear-shaped (or teardrop-shaped) bladder is one whose normal round or ovoid shape has been extrinsically compressed to resemble a pear. The pear may be inverted or upright, depending on how the excess pelvic tissue compresses the bladder.

Pathology

Etiology

Causes of a pear-shaped bladder include:

• pelvic fluid
  • pelvic hematoma: the original description of the inverted pear-shaped bladder was in patients with pelvic trauma and hematoma; it can also be seen in patients receiving anticoagulation therapy
  • bilateral lymphoceles: may develop following radical pelvic lymph node dissection
  • extravasated urine / bilateral urinomas
  • abscess
• pelvic lipomatosis: non-malignant overgrowth of fat around the bladder that causes an inverted pear-shaped bladder
• vascular dilatation
  • bilateral iliac artery aneurysms; upright pear-shape
  • inferior vena cava (IVC) occlusion
    • causes formation of collateral vessels that compress the bladder and form an inverted pear-shaped bladder; in the days of intravenous urograms, the combination of a renal mass and a pear-shaped bladder was a red flag for renal cell carcinoma involving the renal vein and IVC
• symmetric lymph node enlargement, e.g. lymphoma, leukemia
• psoas muscle hypertrophy
  • upright pear-shape: especially in people with narrow pelvises
  • a ratio of the (sum of the widths of the two psoas muscles):(the pelvic width) >0.98 predisposes to bladder compression

Siehe auch:

• pelvine Lipomatose

und weiter:

• fruit inspired signs
• tear-drop