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Positive Contrast Cystogram

  • Thickening of the cranial and ventral urinary bladder wall with irregular cyst-like structure extending into the thickened wall at the vertex
  • Reflux of contrast into the right kidney with mild dilation of the renal pelvis

Double Contrast Cystogram

  • Marked thickening of the apex of the bladder with retention of positive contrast on irregular mucosa.
  • Retention of positive contrast in cyst-like lesion in the wall of the bladder
  • Urachal remnant/diverticulum
  • Chronic cystitis
  • Surgery
  • Culture (may be affected by contrast medium)
  • Cystoscopy
  • This case was handled well by most candidates with a good overall score.
  • Reflux of contrast into the right ureter and right renal pelvis secondary to the cystogram was frequently interpreted as occurring from a previous excretory urogram despite clearly labeled images and lack of contrast in the renal parenchyma, and lack of visualization of the left kidney.
  • Reflux was also frequently interpreted as abnormal due to pyelonephritis or reabsorption of contrast systemically.
  • The thickened bladder wall was occasionally not seen and not interpreted as cystitis
  • Management did not always address the primary and secondary problems