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. 

Identify the abnormality in this IVU?

ANSWER

Correct Answer is Bilateral Ureterocoeles
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.

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17 comments

  1. Anonymous Says:
  2. hydronephrosis

     
  3. your_ozzy Says:
  4. the renal pelvis and calyces are dialted indicating bilateral hydronephrosis, the course of the lower parts of ureter is abnormal

     
  5. Anonymous Says:
  6. left- uretheral stenosis (upper part of urether)

     
  7. Anonymous Says:
  8. ? Pyelonephritis
    Abnormality in IVU: B/L hydronephrosis + after the pelvi- urethral junction, the course of B/L ureters are abnormal.
    L1-2 level stenosis of L ureter

     
  9. Anonymous Says:
  10. ? Pyelonephritis
    Abnormality in IVU: B/L hydronephrosis + after the pelvi- urethral junction, the course of B/L ureters are abnormal.
    L1-2 level stenosis of L ureter

     
  11. Ana Says:
  12. The strictures on the left urether are just muscular contractions, they are not abnormal. the right urether is abnormal, dilated, leading to dilatation of the right calix and hydronephrosis. there is probably an obstruction on the inferior part of the urether, probably intra-vesical, at the ostium. i don't think there is a stenosis on the left urether, there wouldn't be a dilated calibre below the stenosis...

     
  13. Anonymous Says:
  14. bilateral hydronephrosis wid abnormal left ureter contarst lining seems to be an obstruction in the uper ureter and the lowere ureter just before the juntion of ureter wid bladder......so probably a ureteric stones casuing bilateral hydronephrosis...........

     
  15. Anonymous Says:
  16. ureterocoele left side

     
  17. Anonymous Says:
  18. Left and right ureteral junction before bladder obstructed with a stone

     
  19. Anonymous Says:
  20. where can we get a right asnwer? thanks

     
  21. Anonymous Says:
  22. urinari infection

     
  23. Anonymous Says:
  24. ok... it may be an infection... nothing particular on the X-ray

     
  25. honeybee Says:
  26. ิbilateral hydronephrosis

     
  27. There is irregular filling defect over the upper urinary bladder mucosa over the both ureteral outlets. It could be bladder cancer that causes the obstructive hydroureters and hydronephrosis.

     
  28. Anonymous Says:
  29. bilateral hydronephrosis...bladder cancer is unlikely because no hematuria

     
  30. Anonymous Says:
  31. you cant see hydronephrosis there or neither can u say cancer!!! check for opacities in the pelvicalciceal region. ???both of them present with opacities. whilst the suprapubic tenderness could have resulted due to descending calculus.

     
  32. Anonymous Says:
  33. Left ureterocele with partial obstruction (compared with the right).

     

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