ARRS Case of the Week

PEDIATRIC IMAGING

Case Author: Stephen Lehnert, MD and Matthew Wanner, MDl Indiana University School of Medicine

History

A previously healthy, full-term 27-month-old presents to the ED with abdominal pain and pain during urination. Physical examination identified a painful palpable periumbilical mass, so abdominal US and CT of the abdomen and pelvis were obtained.

Findings

Ultrasound images demonstrates an anterior abdominal continuous fluid collection extending from the bladder to the umbilicus.  Contrasted sagittal CT demonstrates similar findings with a fluid collection extending from the bladder to the umbilicus which has rim enhancement. These imaging findings are concerning for infected urachal remnant.