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    • #36805

      Hi Steve,

      I’ve been told when you see floating debris in the bladder, it could be a sign of cystitis. Does this apply for fluid seen in the adnexae/POD/vesicouterine pouch? I’ve recently done 2 patients where the only thing I could see was that free floating debris in the pelvis, both times the reporting radiologists didn’t mention anything about it.

      I was thinking it could of been a sign of pelvic inflammatory disease but very unsure now.


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    • #36808
      Stephen Bird

      Hi Diane,

      My view on debris in the bladder is that it is non specific.
      You may see it with a UTI, but you may also see it if the patient is a little dehydrated so it is of limited diagnostic value and urinalysis is required anyway.

      Debris in POD fluid is similarly non specific.

      In your image it looks like there is some blood product in the fluid in the Pouch.

      This can be due to an ovulation, cyst accident, ectopic pregnancy etc. Anything that creates a bit of fluid with blood product.

      So it is similarly non specific and needs to be clinically correlated.

      For example is a lady presents on day 15 with RIF pain and a negative pregnancy test and is not on the OCP I would be thinking it is Mittleschmertz pain from a large ovulation and the fluid is physiological.

      If the same lady presents but has a positive pregnancy test we have a pregnancy of unknown location and POD fluid with blood characteristics which makes me think it is an ectopic until proven otherwise.

      So it is a good observation, but needs clinical context and may prove to be trivial or serious.

      I guess PID or endometriosis are also on the list.


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