Bilateral vesicoureteric reflux disease

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Recurrent urinary tract infection.

Patient Data

Age: 6
Gender: Male
MRI

MR urography

Moderate dilatation of pelvicalyceal system bilaterally as well as both ureters, more on the right side. Normal renal parenchyma bilaterally with good corticomedullary differentiation. Blunting of right renal calyces and preserved at the left one. Both ureters are moderately dilated and tortuous anong their courses with no evidence of obstruction.

Mild free ascites.

Case Discussion

This case represents moderate dilatation of both pelvicalyceal systems and ureters. These features are suggestive of right grade III and left grade IV vesicoureteric reflux disease. MR urography shows the morphological changes in the ureters and pelvicalyceal system that helps in grading VUR and differentiated it from primary megaureter and obstructive uropathy

Voiding cystourethrogram is the primary diagnostic procedure for evaluation of vesicoureteric reflux (not yet performed) and should be performed after the first well-documented urinary tract infection up to the age of 6 years. Vesicoureteric reflux disease affects renal parenchyma and can lead to reflux nephropathy if untreated.

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Case information

rID: 54895
Case created: 4th Aug 2017
Last edited: 6th Sep 2017
Inclusion in quiz mode: Included

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