This single cut from a CT series after intravenous contrast (given into a lower limb vein) shows opacification of spinal and pre-vertebral veins (immediately behind the aorta). The density of a renogram shows the site of the left kidney. The inferior vena cava opacification is incomplete, outlining a soft tissue mass in the vein and decreasing the effective lumen by at least 75%.
This is an intravenous urogram of a 27 years old white male with a 3 month history of dysuria and bilateral loin pain.He did not have either haematuria or obstructive lowerurinary tract symptoms.On examination of this patient he had bilateral renal angle tenderness and tenderness over the suprapubic area.
Clinical history is suggestive of pyelonephritis.
The kidneys pelvicalyceal systems and proximal ureters appear grossly normal, renal pelvis and calyces are dialted indicating bilateral mild hydronephrosis, implying the possibility of obstruction.(mild left sided hydronephrosis).Both ureters are normal calibre.The lower ends of the ureters cross the bladder wall towards the trigone, but are dilated at their lower end.(cobra head sign) The contrast in the lower end of the ureter is surrounded by a zone of contrast free space within the density of the bladder.
What would be the possible diagnosis in this infant?