Diverticulum of the urinary bladder

Abstract

Bladder diverticulum involves herniations of the mucosa between the smooth muscle fibers of the detrusor. Causes can be acquired, congenital and iatrogenic. They cause serious complications including rupture of the diverticulum and development of acute abdomen, as well as intradiverticular neoplasm. They are often discovered incidentally during radiographic evaluation and study of nonspecific symptoms or signs of the lower urinary system. Diverticulectomy is the procedure of choice in treatment. A 42-year-old man came to the family medicine clinic for a routine check-up. No problems, so far healthy. He has a positive family history of cardiovascular disease and cancer. Ultrasound examination of the abdomen (convex probe 3.5-5 MHz) revealed a large septated cystic change with a diameter of 24x15 mm in the right subhepatic area. Computed tomography in the right half of the hemiabdomen, i.e. in the right infracolic space, identifies a clearly limited thin-walled cystic change of size 108x99x100 mm (LLxAPxCC) that descends in the lower pole into the pelvis. Intraoperatively, it was determined that the cystic change corresponds to a bladder diverticulum. The patient underwent diverticulectomy and Lichtenstein hernioplasty. Recovered, with a stable general condition and satisfactory surgical findings, he was discharged home on the seventh postoperative day. Careful evaluation and ultrasound examination in the family medicine clinic enabled timely diagnosis and successful intervention and prevented serious complications.

Keywords

• urinary bladder
• diverticulum
• obstruction
• congenital development