School ager with progressive abdominal distension and abdominal pain over the last month and new onset urinary retention

Genitourinary
CT of constipation causing bladder outlet obstruction
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.

Published