A pear-shaped urinary bladder on urography, also appreciated as a gourd or inverted tear drop, refers to symmetric bladder compression and elevation and can be seen with the following conditions:
Pelvic hematoma: Most common cause.
Extraperitoeal urinoma:
Pelvic lipomatosis: Also causes increased radiolucency of the pelvis.
Inferior vena cava obstruction: Compression is by engorged pelvic collaterals.
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