Presentation
Recurrent urinary tract infection.
Patient Data
Age: 3 years
Gender: Male
From the case:
Vesicoureteric reflux - grade V
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Control image:
- No abnormal radio-opaque shadow is seen in KUB region.
Prevoid (Cystogram):
- Urinary bladder is normal in outline and shape with smooth mucosal outline. No abnormal filling defects or contrast filled outpouching seen.
Micturation phase:
- Reflux of contrast noted bilaterally reaching upto the pelvicalyceal system with dilated and tortuous bilateral ureters and moderate to gross dilatation of the bilateral pelvicalyceal system resulting in loss of the papillary impression.
Post void Image:
- Minimal residual contrast is seen in the urinary bladder with tortuous and dilated ureters and pelvicalyceal systems.
Case Discussion
Abnormal valve mechanism at vesicoureteric junction result in reflux from the bladder into the upper urinary tract predisposes to pyelonephritis by allowing ascending infection and eventually result in renal parenchymal scarring. The chance of renal parenchymal scarring according to the grading of reflux are 1:
- grade III-V reflux has >20% chance
- grade I-II reflux has 2-3% chance
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