Congenital megaureter with reflux nephropathy
Bilateral flank pain. Small left kidney with hydronephrosis on ultrasound.
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Dilation and elongation of both ureters, left >> right. Small left kidney with pyelonephritic scarring and sloughed necrotic papillae. Single pyelonephritic scar on the right.
Vesicorenal reflux cannot be seen on a CTU, but the appearance of the kidneys is characteristic for chronic recurrent pyelonephritis caused by reflux.