PMC10155723_01
Point of care ultrasound in transverse plane demonstrating an irregularly-shaped bladder filled with anechoic contents and floating sediment.
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However, POCUS performed at the bedside in the supine position revealed an irregularly-shaped, non-distended bladder containing anechoic fluid and floating sediment (Figure 1, Video S1).
Point of care ultrasound in sagittal plane demonstrating the purported disruption in the hyperechoic bladder dome (red arrow).
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Disruption of the hyperechoic bladder dome was seen superiorly leading directly to intra-abdominal free fluid, indicating a likely site of bladder rupture (Figure 2, Video S2).
Point of care ultrasound in sagittal plane demonstrating large amount of free fluid in Morison's pouch with moderate right-sided hydronephrosis.
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Trendelenburg position to increase POCUS sensitivity for gravitationally-dependent free fluid. This evaluation revealed large volume of heterogenous free fluid throughout the right upper quadrant, as well as moderate bilateral hydronephrosis (Figure 3, Video S3).
Computed tomography cystography demonstrating urinary contrast extravasation. In sagittal view (a), the Foley catheter appears filled with contrast. In both sagittal and axial (b) views, the catheter balloon (indicated by the red arrow) can be visualized within the urinary bladder (UB). Contrast extravasation (CE) can be seen emerging through the defect at the bladder dome and residing posteriorly in the supine patient. Eventually, the large amount of extravasated urinary contents has pushed the initial contents and free fluid (FF) into the anterior space as well.
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POCUS images. Placement of a foley catheter drained cloudy yellow urine, and both services expedited CT scan of the abdomen and pelvis with cystography (Figure 4, Video S4).