590 False Positives Bladder Scan in Anuric Patient with Ascites: A Case Report

Introduction Urinary retention is one of the common presentations. Sometimes the clinical examination is unreliable, especially in patients with high BMI, ascites or anasarca. This makes the diagnosis uncertain and the bladder scan readings should be interpreted with caution. Thus, radiological imaging might be required before planning further intervention. Case presentation An 83-year-old woman was admitted under the medical team for sepsis secondary to soft tissue infection. She had multiple comorbidities and morbid obesity with a BMI of 58. Lab results showed an AKI. Initial Bladder scan showed 900 cc. Five uneventful attempts of urinary catheter insertion by the medical team, but still, no urine output and the bladder scan showing positive readings. Supra public catheter was considered. On review, the urinary catheter was in place, no evidence of blood per urethra and the bladder scan showed a reading of around 900 cc. Based on patient’s significantly high BMI, background history, uneventful catheterization and persistent reading on bladder scan. False reading on bladder scan was suspected. Out of hours CTKUB showed significant amount of ascites. Discussion: Bladder scan is sensitive for detecting any fluid in the abdomen not specifically urine in the bladder.Formal imaging should always be considered to confirm diagnosis.