Friday, August 29, 2014

This is an IVU in a child who presented with urinary infection and left loin pain. What does the X-ray show and how is this condition best managed?

The IVU shows missing calyces at the top of the left kidney and a mass in the bladder. The remaining calyces on the left have the appearance of a 'drooping flower'. These findings are typical of an ectopic ureterocele with a non-functioning upper moiety and a large ureterocele in the bladder where the ectopic ureter opens.The lower moiety ureter seen on the IVU is displaced laterally by the dilated ectopic ureter which contains urine but no contrast medium.Treatment is by partial nephroureterectomy to remove the upper moiety & ureter together with either complete excision of the ureterocele from the bladder or simple endoscopic incision. The latter is often preferred because excision may compromise the other (normal) ureter which often then requires reimplantation.



Post a Comment

Twitter Delicious Facebook Digg Stumbleupon Favorites More

Design by Free WordPress Themes | Bloggerized by Lasantha - Premium Blogger Themes | Bluehost Review