School ager with progressive abdominal distension and abdominal pain over the last month and new onset urinary retention Coronal (left) and sagittal (right) images from a CT with IV and oral contrast of the abdomen shows a hugely distended bladder whose dome nearly touches the inferior margin of the liver. There is a marked amount of stool throughout the colon, especially in the rectum where a fecaloma is pinching off the bladder neck and urethra. The diagnosis was constipation causing bladder outlet obstruction.