Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

This patient was born with sacral myelomeningocele and eventually had placement of an artificial sphincter. She was still wet and so an ileocystoplasty was done. Post-op, she had a suprapubic tube as well as a Foley catheter in the bladder (from the urethra). The suprapubic tube was not draining. A cystogram through the Foley catheter seemed to show, in frontal view, that the suprapubic tube was in the newly augmented bladder (Figure 1), but on a lateral view, it was clear that the tip of the tube was out of the augmenting section and posterior to it (Figure 2). These images show the importance of obtaining images at right angles to one another to avoid thinking that a tube is in the bladder when, in fact, it is not.