Pelviureteric junction obstruction - massive

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis almost certain


Referred for evaluation of long-standing left hydronephrosis.

Patient Data

Age: 25 years
Gender: Male

The left kidney shows massive hydronephrotic changes in the form of marked dilatation of the renal pelvis and collecting system, giving the appearance of a bag of water with the subsequent near total loss of the renal parenchyma and cortical thickness. No visualized stones or calcification foci within. The left ureter appears of collapsed caliber medially displaced by the enlarged kidney. The picture is highly suggestive of PUJ obstruction with subsequent marked back pressure changes as described.

Case Discussion

The case represents typical classic appearances of marked left pelviureteric junction obstruction.

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