Crossing vessels causing uretero-pelvic junction obstruction
Chronic dull left flank pain. Ultrasonography reported left sided hydronephrosis without nephrolithiasis.
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Left sided grade II hydronephrosis (according to Onen's grading) without parenchymal loss.
No nephrolithiasis or hydroureter.
Left renal vein branches cross the ureteropelvic junction before joining the renal hilum. This results in extrinsic compression of the pelviureteric junction; best seen on coronal images.
Crossing vessels causing pelviureteric junction obstruction is a known entity. Contrast enhanced CT can demonstrate the vascular branches crossing and causing extrinsic compression over the pelviureteric junction.