Presentation
History of recurrent urinary tract infections.
Patient Data
Both kidneys are enlarged in size.
- right kidney measures 11.6 cm
- left kidney measures 13.2 cm
There is duplication of bilateral pelvicalyceal systems and ureters with gross hydroureteronephrosis involving bilateral upper moieties. (L>R)
Pelvicalyceal systems and ureters of bilateral lower moieties are normal.
The upper moiety ureters are dilated (2.5 cm) and show tortuous course with insertion site more medially and distally compared to the lower moiety ureters - possibly in prostatic urethra / bladder neck.
The upper moiety renal parenchyma is thinned with minimal contrast excretion at the time of the 15 minutes delayed scan. The lower moiety shows normal contrast excretion at the time of the 15 minutes delayed scan.
There is also a 14 x 7 mm simple cyst seen in interpolar region of right kidney. A tiny concretion is seen in seen in interpolar calyx of right kidney.
URINARY Bladder: Wall thickness is normal. No Luminal mass lesions / Polyps.
Aorta and Inferior Vena cava are normal.
No free fluid in the abdomen.
Rest of the solid abdominal organs are normal.
Visualized bones are grossly normal.
There is duplication of bilateral pelvicalyceal systems and ureters with gross hydroureteronephrosis involving bilateral upper moieties. (L>R)
The upper moiety renal parenchyma is thinned.
The upper moiety ureters are dilated and show tortuous course with insertion site more medially and distally - possibly in prostatic urethra / bladder neck.
Case Discussion
Bilateral duplicated pelvicalyceal systems and ureters with gross hydroureteronephrosis (L>R) of the upper moieties.
Ectopic insertion sites of upper moiety ureters as described above.
Classic example of Duplex collecting system with Weigert-Meyer law.
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