Ureteropelvic junction obstruction

Rakhee Gawande, Heike E. Daldrup-Link, Beverley Newman

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Imaging description A nine-year-old boy presented with intermittent episodic left flank pain consistent with Dietl’s crisis (=sudden attack of acute lumbar and abdominal pain accompanied by nausea and vomiting, caused by distension of the renal pelvis due to kinking of the ureter or other obstruction of urine flow from the kidney to the ureter). An initial ultrasound showed moderate left renal pelvocaliectasis (Fig. 65.1a). A follow-up study one month later showed mild dilatation of the left renal pelvis (Fig. 65.1b) and a follow-up ultrasound six months later when the child was again acutely symptomatic showed moderate hydronephrosis with marked dilatation of the renal pelvis (Fig. 65.1c). A review of serial ultrasounds of the kidneys revealed fluctuating mild to moderate hydronephrosis of the left kidney over several years. The imaging appearance was strongly suggestive of intermittent ureteropelvic junction (UPJ) obstruction. Importance. UPJ obstruction is the most common cause of hydronephrosis in children and accounts for approximately 64% of cases. It is defined as a partial or total obstruction at the point where the renal pelvis narrows to form the ureter. It is found more commonly in boys and frequently involves the left kidney. It can be bilateral in 10–40% of cases. Ipsilateral vesicoureteral reflux is seen in about 10% of patients with UPJ obstruction. Various congenital renal anomalies may be associated with UPJ obstruction, including contralateral multicystic dysplastic kidney (MCDK), renal agenesis, duplicated renal collecting system, horseshoe kidney (Fig. 65.2), and ectopic kidney. Other associated congenital anomalies include imperforate anus, congenital heart disease, esophageal atresia, and VATER syndrome.

Original languageEnglish (US)
Title of host publicationPearls and Pitfalls in Pediatric Imaging
Subtitle of host publicationVariants and Other Difficult Diagnoses
PublisherCambridge University Press
Pages276-280
Number of pages5
ISBN (Electronic)9781139084239
ISBN (Print)9781107017498
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

Fingerprint

Kidney
Kidney Pelvis
Hydronephrosis
Ureter
Dilatation
Multicystic Dysplastic Kidney
Imperforate Anus
Flank Pain
Esophageal Atresia
Vesico-Ureteral Reflux
Acute Pain
Nausea
Abdominal Pain
Vomiting
Heart Diseases
Urine

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gawande, R., Daldrup-Link, H. E., & Newman, B. (2012). Ureteropelvic junction obstruction. In Pearls and Pitfalls in Pediatric Imaging: Variants and Other Difficult Diagnoses (pp. 276-280). Cambridge University Press. https://doi.org/10.1017/CBO9781139084239.066

Ureteropelvic junction obstruction. / Gawande, Rakhee; Daldrup-Link, Heike E.; Newman, Beverley.

Pearls and Pitfalls in Pediatric Imaging: Variants and Other Difficult Diagnoses. Cambridge University Press, 2012. p. 276-280.

Research output: Chapter in Book/Report/Conference proceedingChapter

Gawande, R, Daldrup-Link, HE & Newman, B 2012, Ureteropelvic junction obstruction. in Pearls and Pitfalls in Pediatric Imaging: Variants and Other Difficult Diagnoses. Cambridge University Press, pp. 276-280. https://doi.org/10.1017/CBO9781139084239.066
Gawande R, Daldrup-Link HE, Newman B. Ureteropelvic junction obstruction. In Pearls and Pitfalls in Pediatric Imaging: Variants and Other Difficult Diagnoses. Cambridge University Press. 2012. p. 276-280 https://doi.org/10.1017/CBO9781139084239.066
Gawande, Rakhee ; Daldrup-Link, Heike E. ; Newman, Beverley. / Ureteropelvic junction obstruction. Pearls and Pitfalls in Pediatric Imaging: Variants and Other Difficult Diagnoses. Cambridge University Press, 2012. pp. 276-280
@inbook{819488fb3de14b3988207bbe10862697,
title = "Ureteropelvic junction obstruction",
abstract = "Imaging description A nine-year-old boy presented with intermittent episodic left flank pain consistent with Dietl’s crisis (=sudden attack of acute lumbar and abdominal pain accompanied by nausea and vomiting, caused by distension of the renal pelvis due to kinking of the ureter or other obstruction of urine flow from the kidney to the ureter). An initial ultrasound showed moderate left renal pelvocaliectasis (Fig. 65.1a). A follow-up study one month later showed mild dilatation of the left renal pelvis (Fig. 65.1b) and a follow-up ultrasound six months later when the child was again acutely symptomatic showed moderate hydronephrosis with marked dilatation of the renal pelvis (Fig. 65.1c). A review of serial ultrasounds of the kidneys revealed fluctuating mild to moderate hydronephrosis of the left kidney over several years. The imaging appearance was strongly suggestive of intermittent ureteropelvic junction (UPJ) obstruction. Importance. UPJ obstruction is the most common cause of hydronephrosis in children and accounts for approximately 64{\%} of cases. It is defined as a partial or total obstruction at the point where the renal pelvis narrows to form the ureter. It is found more commonly in boys and frequently involves the left kidney. It can be bilateral in 10–40{\%} of cases. Ipsilateral vesicoureteral reflux is seen in about 10{\%} of patients with UPJ obstruction. Various congenital renal anomalies may be associated with UPJ obstruction, including contralateral multicystic dysplastic kidney (MCDK), renal agenesis, duplicated renal collecting system, horseshoe kidney (Fig. 65.2), and ectopic kidney. Other associated congenital anomalies include imperforate anus, congenital heart disease, esophageal atresia, and VATER syndrome.",
author = "Rakhee Gawande and Daldrup-Link, {Heike E.} and Beverley Newman",
year = "2012",
month = "1",
day = "1",
doi = "10.1017/CBO9781139084239.066",
language = "English (US)",
isbn = "9781107017498",
pages = "276--280",
booktitle = "Pearls and Pitfalls in Pediatric Imaging",
publisher = "Cambridge University Press",

}

TY - CHAP

T1 - Ureteropelvic junction obstruction

AU - Gawande, Rakhee

AU - Daldrup-Link, Heike E.

AU - Newman, Beverley

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Imaging description A nine-year-old boy presented with intermittent episodic left flank pain consistent with Dietl’s crisis (=sudden attack of acute lumbar and abdominal pain accompanied by nausea and vomiting, caused by distension of the renal pelvis due to kinking of the ureter or other obstruction of urine flow from the kidney to the ureter). An initial ultrasound showed moderate left renal pelvocaliectasis (Fig. 65.1a). A follow-up study one month later showed mild dilatation of the left renal pelvis (Fig. 65.1b) and a follow-up ultrasound six months later when the child was again acutely symptomatic showed moderate hydronephrosis with marked dilatation of the renal pelvis (Fig. 65.1c). A review of serial ultrasounds of the kidneys revealed fluctuating mild to moderate hydronephrosis of the left kidney over several years. The imaging appearance was strongly suggestive of intermittent ureteropelvic junction (UPJ) obstruction. Importance. UPJ obstruction is the most common cause of hydronephrosis in children and accounts for approximately 64% of cases. It is defined as a partial or total obstruction at the point where the renal pelvis narrows to form the ureter. It is found more commonly in boys and frequently involves the left kidney. It can be bilateral in 10–40% of cases. Ipsilateral vesicoureteral reflux is seen in about 10% of patients with UPJ obstruction. Various congenital renal anomalies may be associated with UPJ obstruction, including contralateral multicystic dysplastic kidney (MCDK), renal agenesis, duplicated renal collecting system, horseshoe kidney (Fig. 65.2), and ectopic kidney. Other associated congenital anomalies include imperforate anus, congenital heart disease, esophageal atresia, and VATER syndrome.

AB - Imaging description A nine-year-old boy presented with intermittent episodic left flank pain consistent with Dietl’s crisis (=sudden attack of acute lumbar and abdominal pain accompanied by nausea and vomiting, caused by distension of the renal pelvis due to kinking of the ureter or other obstruction of urine flow from the kidney to the ureter). An initial ultrasound showed moderate left renal pelvocaliectasis (Fig. 65.1a). A follow-up study one month later showed mild dilatation of the left renal pelvis (Fig. 65.1b) and a follow-up ultrasound six months later when the child was again acutely symptomatic showed moderate hydronephrosis with marked dilatation of the renal pelvis (Fig. 65.1c). A review of serial ultrasounds of the kidneys revealed fluctuating mild to moderate hydronephrosis of the left kidney over several years. The imaging appearance was strongly suggestive of intermittent ureteropelvic junction (UPJ) obstruction. Importance. UPJ obstruction is the most common cause of hydronephrosis in children and accounts for approximately 64% of cases. It is defined as a partial or total obstruction at the point where the renal pelvis narrows to form the ureter. It is found more commonly in boys and frequently involves the left kidney. It can be bilateral in 10–40% of cases. Ipsilateral vesicoureteral reflux is seen in about 10% of patients with UPJ obstruction. Various congenital renal anomalies may be associated with UPJ obstruction, including contralateral multicystic dysplastic kidney (MCDK), renal agenesis, duplicated renal collecting system, horseshoe kidney (Fig. 65.2), and ectopic kidney. Other associated congenital anomalies include imperforate anus, congenital heart disease, esophageal atresia, and VATER syndrome.

UR - http://www.scopus.com/inward/record.url?scp=84923429438&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923429438&partnerID=8YFLogxK

U2 - 10.1017/CBO9781139084239.066

DO - 10.1017/CBO9781139084239.066

M3 - Chapter

SN - 9781107017498

SP - 276

EP - 280

BT - Pearls and Pitfalls in Pediatric Imaging

PB - Cambridge University Press

ER -