31-year-old female with pelvic pain, suprapubic pain, discharge, and fever. Evaluate for urethral diverticulum versus Gardner duct cyst versus abscess. PELVIS:UTERUS, ADNEXA: 3.0 x 2.6 x 2.7 cm U-shaped fluid collection posterior to the urethra. This collection conforms around the shape of the urethra and is located at the level of the pubic symphysis. A definite tract from the urethra to this collection is not visualized. This collection appears separate from the vagina. An internal fluid-fluid level is noted, suggestive of proteinaceous debris, possibly from stasis of fluid. There is peripheral soft tissue enhancement around this collection suggestive of infection or inflammation.The uterus is anteriorly located with foci of increased T2 signal in the anterior myometrium, likely reflecting prior C-section. The ovaries are normal in appearance. BLADDER: No significant abnormality noted.LYMPH NODES: Bilateral pelvic lymphadenopathy. The largest visualized lymph node, in the lower abdominal retroperitoneum, measures 2.4 cm in short axis (series 901, image 15), similar to the prior CT.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1.U-shaped fluid collection posterior to the urethra. Though a definite tract to the urethra is not visualized, this most likely represents a urethral diverticulum by appearance. Peripheral enhancement around this collection likely reflects concomitant infection or inflammation.2.Pelvic and lower abdominal lymphadenopathy again seen, similar to the prior abdominal CT. This is unlikely to be related to the urethral diverticulum and is nonspecific but may represents an inflammatory process such as sarcoidosis or neoplastic condition such as lymphoma.