Case 28

A sixty four-year-old female came to our hospital for dysuria at midnight. She was diagnosed as urinary cystitis at a local clinic the day before yesterday. She had a habit of drinking a bottle of spirit for two days or a bottle of wine for one day. Tension of lower abdomen below naval was found. Abdominal echo showed a fully expanded urinary bladder but neither dilatation of renal pelvis or vescico-ureteral reflux. Urine of 1050 ml was excreted by urinary tube insertion. Laboratory test; Creatinin 0.96 mg/dL; eGFR 45.4 ml/min/1.73 m2 White blood cells 11120/mm3, Neutrophils 85.0%. CRP 11.06 mg/dL, Natural urine excretion of 450 ml for 8 hours via a urinary tube was excreted. The urinary tube was taken out at 1 PM. A urinary tube was inserted again because dysuria continued until 4 PM. She felt desire to urinate but recognized to be unable to excrete urine again.
 She consented to receive contrast-enhanced CT to examine the whole urinary tract.

What is the appropriate imaging diagnosis ?

1. Prolapse of uterine myoma

2. Uterine cervical cancer

3. Adenoma malignum

4. Paraurethral (Skene gland) abscess

5. Urethral tumor

answer

2016.10.19