Caudal regression syndrome with neurogenic bladder

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Neurogenic bladder with recurrent urinary tract infections.

Patient Data

Age: 20 years
Gender: Female

Distended, thick-walled urinary bladder with irregular pseudo-diverticular wall giving a Christmas tree appearance with bilateral hydronephrosis and hydroureter more marked on the left with thinning of the cortical renal parenchyma and delayed excretion. Evidence of left vesicoureteric reflux (contrast within the ureter while no contrast in the renal cavities). Features in keeping with a neurogenic bladder. Enlarged para-aortic lymph nodes are noted.

The spinal cord is blunted at T11-T12 level, giving a cigar-shaped appearance of the conus medullaris with associated hypoplastic sacrum and agenesis of the coccyx. Features in keeping with a caudal regression syndrome. 

Case Discussion

Typical MRI features of a neurogenic bladder in a patient with a caudal regression syndrome.

No other associated anomalies seen in this case.

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