PMC10036306_01
A) Sagittal multiplanar reconstruction (MPR) revealing the dimensions of the bladder. We can observe the loops of the large intestine dilated above the bladder. There was no associated dilation of the small intestine. We observed an anterior interposition of the colonic loops to the liver (Chilaiditi syndrome). B) Sagittal MPR revealing an abrupt change in the calibre of the sigmoid colon (yellow arrowhead). C) Axial MPR identifying pyeloureteral dilation compatible with grade III hydronephrosis.
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A non-contrast-enhanced abdominal computed tomography (CT) scan revealed a significant bladder dilation of 20.2 x 10.3 x 11.8 cm (Fig. 1 A) with bilateral hydronephrosis. The considerable bladder distension compressed the rectum and sigmoid colon against the sacrum (Fig. 1B) causing an obstructive ileus with distension of the entire colon. For all these reasons, the patient was diagnosed with acute obstructive renal failure, likely of infravesical origin with grade III bilateral hydronephrosis (Fig. 1C) and intestinal obstruction secondary to the compression exerted by the bladder.