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CT scan done. Free fluid identified within the pelvis which is abnormal. What should be done next?

Apr 2013
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General Surgeon
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7 years old boy CT result:

"There is a small of free fluid identified within the pelvis which is abnormal"
What we have to do?
Posted Thu, 25 Apr 2013 in X-ray, Lab tests and Scans
Answered by Dr. Ivan R. Rommstein 3 hours later
Hi and welcome to XXXXXXX
Well, I dont get what did they mean by"abnormal". Small amount of pelvic clear fluid may be normal and is found in many people. If CT identified blood or pus then it is abnormal. So it would be good if you tell me what is the amount of fluid and its density.
It is questionable is this finding, even if we consider it is abnormal, related to his symptoms.It he was a girl it would be sign of reproductive organs infection, in this case,severe cystitis could cause pelvic fluid . In his age this symptoms must be evaluated. Some urogenital congenital anomalies can be manifested on this way and at this age. Any uroinfection in boys is considered complicated and various disorders such as vesicoureteral reflux, megaureter and hydronephrosis can cause it. It would be seen on CT scan,but kidney function wouldnt. Intravenous urography or scintigraphy would show kidney function and urogenital anomalies as well. Stones arent often in children, but are possible. Also, those disorders i ve mentioned can be reason for his bladder infection and kidney stones.
Despite all this, it is possbile that he had urinary infection with no specific reason. It can be treated conservatively, but if it happens again I suggest you to do tests i ve said and consult nephrologist or child urologist.
Hope I have answered your query. If you have any further questions I will be happy to help"

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Follow-up: CT scan done. Free fluid identified within the pelvis which is abnormal. What should be done next? 2 days later
We had an appointment with child urologist. he said this is a bladder infection plus constipation. Child is taking BACTRIM for 3 days, no results, same pain in low back and abdomen, same complaints. Child urinates with no problem, no pain by urination. Still did not receive urine and blood test results. What doctor we have to see? Pediatric surgeon?
Answered by Dr. Ivan R. Rommstein 1 hour later
Hi again.
I ve seen CT report and those nonspecific findings.
It can be infection and kindey stone. Also it can be empirically treated by antibiotics as your doctos said, but it might be better if urine test and urinoculture was done and type and amount of bacterias verified.
But, it is considered that every uroinfection in boys at this age should not be ignored and it is recommended to evaluate this. It can be urogenital disorder such as vesicoureteral reflux which is treated by pediatric surgeon so if you want to be sure consult him.This isnt something very possible and often,and isnt serious so wait for a week more and see will there be improvements after antibiotic therapy and stool regulation.
I am sure everything will be fine,wish you good luck.
If you have more questions I am here for you.
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