What causes a pear-shaped bladder appearance on imaging?
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A pear-shaped bladder on pelvic imaging typically results from symmetric extrinsic compression or displacement of the urinary bladder by conditions such as pelvic hematoma, pelvic lipomatosis, inferior vena cava obstruction, lymphadenopathy, or hypertrophied adjacent muscles like the psoas or iliacus. These conditions either compress the bladder from both sides or displace it superiorly, leading to its characteristic elongated and narrowed shape.
Why is it called so?
The term pear-shaped bladder describes the bladder’s appearance after extrinsic compression, resembling the shape of a pear. This term is used due to the bladder’s elongated and narrowed configuration, which is distinct from its normal round or ovoid shape.
Pathophysiology
The pear-shaped bladder develops due to external forces that compress or displace the bladder symmetrically. For instance, in pelvic lipomatosis, excessive fat accumulation in the pelvis anteriorly displaces the bladder, causing it to take on a pear-like shape. Similarly, in cases of inferior vena cava obstruction, engorged collateral vessels can compress the bladder from both sides, resulting in its characteristic elongation and narrowing.
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