Book contents
- Frontmatter
- Contents
- Contributors
- PART I PLAIN RADIOGRAPHY
- PART II ULTRASOUND
- 12 Introduction to Bedside Ultrasound
- 13 Physics of Ultrasound
- 14 Biliary Ultrasound
- 15 Trauma Ultrasound
- 16 Deep Venous Thrombosis
- 17 Cardiac Ultrasound
- 18 Emergency Ultrasonography of the Kidneys and Urinary Tract
- 19 Ultrasonography of the Abdominal Aorta
- 20 Ultrasound-Guided Procedures
- 21 Abdominal—Pelvic Ultrasound
- 22 Ocular Ultrasound
- 23 Testicular Ultrasound
- 24 Abdominal Ultrasound
- 25 Emergency Musculoskeletal Ultrasound
- 26 Soft Tissue Ultrasound
- 27 Ultrasound in Resuscitation
- PART III COMPUTED TOMOGRAPHY
- PART IV MAGNETIC RESONANCE IMAGING
- Index
- Plate Section
20 - Ultrasound-Guided Procedures
from PART II - ULTRASOUND
Published online by Cambridge University Press: 07 December 2009
- Frontmatter
- Contents
- Contributors
- PART I PLAIN RADIOGRAPHY
- PART II ULTRASOUND
- 12 Introduction to Bedside Ultrasound
- 13 Physics of Ultrasound
- 14 Biliary Ultrasound
- 15 Trauma Ultrasound
- 16 Deep Venous Thrombosis
- 17 Cardiac Ultrasound
- 18 Emergency Ultrasonography of the Kidneys and Urinary Tract
- 19 Ultrasonography of the Abdominal Aorta
- 20 Ultrasound-Guided Procedures
- 21 Abdominal—Pelvic Ultrasound
- 22 Ocular Ultrasound
- 23 Testicular Ultrasound
- 24 Abdominal Ultrasound
- 25 Emergency Musculoskeletal Ultrasound
- 26 Soft Tissue Ultrasound
- 27 Ultrasound in Resuscitation
- PART III COMPUTED TOMOGRAPHY
- PART IV MAGNETIC RESONANCE IMAGING
- Index
- Plate Section
Summary
SUPRAPUBIC BLADDER CATHETERIZATION
Indications
Urinalysis is critical in evaluating and treating patients with suspected urinary tract infections or complex urosepsis. Urethral catheterization is a standard method for obtaining urine samples, but is not always possible or successful. Ultrasound evaluation of bladder volume has been shown to significantly improve catheterization success rates in children when compared to blind catheterization (1,2). Urethral catheterization may not be possible secondary to obstruction (e.g., prostatic hypertrophy, urethral stricture), or it may be contraindicated secondary to trauma (e.g., suspected urethral injury). Placement of a suprapubic catheter for bladder decompression is indicated in such cases. Ultrasound guidance for suprapubic bladder catheterization has been shown to improve success rates, decrease number of attempts, and decrease complications (3–9).
Anatomical Considerations
The urinary bladder is protected by the pelvis in adults and older children. In younger children, the bladder may extend into the abdomen. Anechoic urine provides an excellent acoustic window, and the bladder, with rounded walls surrounding dark urine, is usually easy to visualize (Fig. 20.1). An empty bladder is more difficult to visualize, and sonographers should look for collapsed walls containing small amounts of urine (Fig. 20.2) similar to a collapsed gallbladder (see Chapter 14). Bowel gas may impede a clear view of the bladder.
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- Clinical Emergency Radiology , pp. 287 - 312Publisher: Cambridge University PressPrint publication year: 2008