Chronic pelviureteric junction obstruction

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Impaired renal function. Right hydronephrosis on ultrasound scan.

Patient Data

Age: 55 years
Gender: Female
This study is a stack
Axial renal
excretory phase
This study is a stack
Coronal renal
excretory phase
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Info

Severe right-sided hydronephrosis to the level of the pelviureteric junction. Ureter normal in caliber.

Advanced cortical thinning of the right kidney to 3 mm.

No meaningful excretion in the right collection system.

Normal left kidney.

Case Discussion

A late presentation of a pelviureteric junction obstruction. Abrupt caliber change at the pelviureteric junction, with severe obstruction and cortical thinning.

The minimal excretion from the right kidney suggests this has minimal residual function. A MAG3 scan would clarify this.

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