Vesicoureteric reflux: grade 4

Case contributed by Dr Eric F Greif


Child with recurrent urinary tract infection

Patient Data

Age: 4
Gender: Female

Ultrasound of the Kidneys

Dilation of the renal calycies.


Voiding Cystourethrogram (VCUG).

Pre-void contrast filled bladder demonstrated bilateral vesico-ureteral reflux (VUR) with mildly tortuous and moderately dilated ureters, with contrast reaching blunted dilated calyces (low pressure VUR)

After voiding, the collecting systems fill even further, compatible with a component of high pressure VUR.

Findings are keeping with bilateral type 4 vesico-ureteral reflux. 

Case Discussion

Four year old girl presented with second urinary tract infection. Therefore, a voiding cystourethrogram (VCUG) was performed. The images demonstrate bilateral pre-void grade 4 vesicoureteral reflux. 

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Case information

rID: 30032
Published: 1st Aug 2014
Last edited: 9th Aug 2017
Inclusion in quiz mode: Included

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