Giant Urinary Bladder Diverticulum with Intraluminal Calculi Presenting as Acute Oliguria in an Elderly Female: A Radiological Diagnostic Challenge
Urinary bladder diverticula are herniations of the bladder mucosa through the detrusor muscle and may be congenital or acquired, most commonly secondary to chronic bladder outlet obstruction in elderly patients.While most bladder diverticula are small and asymptomatic, giant bladder diverticula are rare and may present with atypical symptoms and diagnostic challenges, particularly on ultrasonography.Case Presentation: A 70-year-old female presented with acute onset oliguria, burning micturition, and perineal discomfort . Initial ultrasonography, showed a large echogenic intravesical mass with dense posterior acoustic shadowing, raising differential diagnoses including a stone-filled diverticulum, intraluminal calculi, or a calcified bladder mass. Due to limited characterization on ultrasonography, non- contrast CT KUB was performed, which demonstrated a giant postero-lateral urinary bladder diverticulum with a narrow neck, completely filled with multiple densely calcified calculi, with relative decompression of the main bladder lumen.The patient subsequently underwent endoscopic stone removal, confirming the imaging findings.Conclusion: This case highlights the diagnostic limitations of ultrasonography in stone-filled bladder diverticula and underscores the pivotal role of CT in definitive diagnosis, anatomical delineation, and surgical planning.
Keywords: Urinary bladder diverticulum; bladder calculi; computed tomography
