An 87-year-old man presented to the emergency room with increasing abdominal fullness and girth for weeks. He had a long history of urinary urgency and frequency. Physical examination revealed marked abdominal distention with a suspicious mass in the central abdomen. Complete blood count and biochemistry tests were all within the normal range. Urinalysis disclosed hematuria and pyuria (11-20/HPF and 11-20/HPF, respectively). A plain radiograph showed increased density in the mid-to-lower abdomen, suggestive of an intraabdominal mass lesion and an abdominal ultrasound displayed a huge cystic structure with an internal septum occupying the mid-to-lower abdomen. Contrast-enhanced computed tomography revealed a cyst with septum, 24 X 23 X 15 cm, occupying the whole abdominal/pelvic cavity (Figure 1). There was a connection between the "cyst" and urinary bladder (UB). Fluid-fluid levels between contrast medium and urine were identified in the dependant part of the UB and in the dilated cyst (Figure 2). Dilated diverticulum (D) from UB was diagnosed and 4500 mL of retained urine was drained out after urinary catheterization. The abdominal "mass" lesion disappeared immediately.
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机译：一名87岁的男子因腹部饱满度和周长增加而出现在急诊室数周。他有尿急和尿频的悠久历史。体格检查发现腹部明显肿胀，中央腹部可疑肿块。全血细胞计数和生化检查均在正常范围内。尿液分析显示血尿和脓尿（分别为11-20 / HPF和11-20 / HPF）。普通的X射线照片显示中下腹部密度增加，提示腹部内块状病变，腹部超声显示巨大的囊性结构，内部隔膜占据中下腹部。对比增强的计算机体层摄影术显示，一个囊肿的间隔为24 X 23 X 15 cm，占据了整个腹腔/盆腔（图1）。 “囊肿”与膀胱（UB）之间存在联系。在UB的依赖部位和扩张的囊肿中发现了造影剂和尿液之间的流体水平（图2）。诊断出来自UB的憩室扩张（D），并在导尿后排空了4500 mL残留尿液。腹部“肿块”病变立即消失。
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