Incomplete ureteral duplications bifid ureter, bifid pelvis are caused by a division of a single ureteric bud on its way to the metanephric blastema. Blindending bifid ureter in a woman with urinary tract infection and a duplicated renal pelvis in her twin sister are reported. On december 3rd, i went to the er for what they though was a kidney stone. Minor signs of organ atrophy present flat papillae and blunt fornices. A bifid renal pelvis means that the collecting system in the kidney is divided into 2 sections. Bilateral bifid ureter with accessory renal artery. Unilateral incomplete bifid ureter presenting with calculus. An ultrasound can determine if these are simple vs complex cysts, the latter could be worrisome.
Later studies confirmed this, with duplicated ureters being found in 1 in 125 patients 0. Radiological appearances of nonvascular renal anatomical variants. Urine production occurs in the renal pyramids and overlying areas of renal cortex. An intravenous urography objectified urethral stenosis and left ureter bifidity, which has been discovered incidentally. One of a series of ivp films at 15 minutes after injection of contrast medium showed. Therefore, we thought that it would be worthwhile to present such a case.
A single renal vein was seen draining into the inferior vena cava. Diagnosis was missed in the initial imaging modalities because apart from the dilated pelvis, there was no evidence of hydronephrosis or calculus seen, hence a diagnosis of extrarenal pelvis. It has been associated with goltzs syndrome7 high cephalad kidney, duplication of pelvis, 8 and unilateral pulmonary hypoplasia. It is the portion of the kidney where either two or three major calyces join. The renal pelvis lies within the hilus of the kidney and receives major. Case report a 2yearold girl was admitted to the babies and childrensa hospital of cleveland in the spring of 1964 with the chief complaint of. Perlmutter from the department of pediatric urology, childrenas hospital of michigan and department of urology, wayne state university school of medicine, detroit, michigan abstract congenital obstruction of only 1 portion of the renal collecting system is almost always associated. Duplicated ureter or duplex collecting system is a congenital condition in which the ureteric. Thirtyone patients with anomalous andor pathological conditions in the duplication of the renal pelvis and ureter were studied in order to analyze the urographic findings. Radiological imaging of the kidney medical radiology diagnostic imaging. Kidney duplication an overview sciencedirect topics.
Case reports segmental hydronephrosis with a bifid intrarenal pelvis bruce h. Bilateral bifid ureter with unilateral renal vasculature. The renal pelvis and calyces are dilated, and the renal cortex is markedly thinned. The pelvis is almost completely enclosed in the deep indentation on the concave side of the kidney, the sinus. Its vascularisation was by a single renal artery originating from aorta. Borders between renal pelvis and calyces are missing. Renal, bladder, and adrenal ultrasound radiology key. Right renal pelvic calculus mimicking an extrarenal pelvis. Ureter duplication an overview sciencedirect topics. Obstructed bifid uretereric system causing unilateral hydronephrosis.
Individualized treatment on the basis of pre and intraoperative findings is mandatory to obtain effective treatment. Relieve the pressure by relieving the obstruction of the urine flow between kidney and bladder where the ureter or ureters co. Renal, bladder, and adrenal ultrasound imaging technique kidneys a renal us examination typically includes sonography of both kidneys, the perirenal areas, the aorta, inferior vena cava ivc, and the urinary bladder. Microscopically, the muscle layers in the area of the ureteropelvic junction may be normal, attenuated, disorganized, or predominantly longitudinal. Dec 27, 2007 hello, i have a question about which test should be done. The renal pelvis, which is the commencement of the ureter, may be bifid. In the previous studies, bifid ureter had been detected in association with various congenital anomalies and defects. Also, the renal artery may give off branches and the renal vein may receive tributaries.
Robotassisted pyeloureterostomy in bifid renal pelvis. Bifid renal pelvis and partial duplication anomalies. Bifid ureter may remain asymptomatic and create academic interest only lest it may cause complications like ureteric stenosis, urinary lithiasis and pyelonephritis. In 1948, nordmark described bifid ureters, along with bifid renal pelves, as the most common malformation of the urinary system.
Robotassisted pyeloureteroanastomosis is a feasible option in cases of bifid renal pelvis with preserved function of both upper and lower moieties. Duplex kidney is the commonest congenital abnormality of the urinary tract with a. Undifferentiated primitive cellsthe ureteric bud ultimately gives rise to the ureter, renal pelvis, calyces, and collecting tubules of the renal medulla. It is not the same as polycystic kidney disease, where many cysts on both kidneys could lead to kidney failure.
Ct can delineate all abnormalities essentially, especially when performed during the excretory ivp phase contrast outlining the collecting systems. This can occur when there is a blockage above the level of the bladder in the ureter. Seven cases of bifid ureter with a blindending branch are presented. According to the reporting radiologist, back pressure changes were observed in the affected ureter, and the hydronephrotic changes in the left kidney were easy. Jul 20, 20 during routine dissection of 82yearold female cadaver with no known unfavorable medical history, we observed bilateral bifid ureter and variation in arterial supply of left kidney only. Renal pelvis, ask a doctor about renal pelvis doctors. The blindending bifid ureter terminated as a fibrous cord with a.
It provides excellent anatomic information but does not necessarily differentiate a bifid renal pelvis from a bifid ureter or two complete ureters. In symptomatic patients, bifid ureteric systems are. Bilateral malrotation and a congenital pelvic kidney with. They lie in the ordervein, artery and ureter with the ureter posterior most. Renal pelvis, enlarged upper end of the ureter, the tube through which urine flows from the kidney to the urinary bladder. Renal pelvis definition of renal pelvis by medical dictionary. Renal pelves definition of renal pelves by medical dictionary. The presence of bifid ureter and multiple renal arteries were observed on both.
Congenital anomalies of kidney and ureter longdom publishing sl. The metanephric blastema develops from the caudal portion of the nephrogenic cord and gives rise to the excretory part of the kidney. Renal pelvis is a funnel shaped structure in each kidney that is formed at one end by the expanded upper portion of ureter lying in the renal sinus and at the other end by the union of the calyxes of the kidney. May 11, 2020 the renal pelvis refers to the funneling area of the kidney responsible for urine collection. Small cell carcinoma of the renal pelvis is a rare and aggressive neoplasm with limited survival due to a high incidence of occult metastasis at the time of presentation. Segmental hydronephrosis with a bifid intrarenal pelvis. Kidney renal pelvis doctor answers on healthcaremagic. A large renal calculus that completely fills the renal pelvis. However, when pain became recurrent and persistent, he had a noncontrast computed tomography ct examination, which revealed a calculus in the renal pelvis. Rarely, one of the branches of a bifid ureter will be blindending and will not unite 2. The hilum of the kidney has the renal vein, the renal artery and the pelvis of the ureter renal pelvis. Renal pelvis in hindi, translation, englishhindi dictionary. No filling defect or other cause of hematuria identified.
Obstructed bifid uretereric system causing unilateral. Ivp it is a radiographic examination of urinary tract including renal parenchyma, calyces and pelvis after iv injection of contrast. Significant signs of renal atrophy thin parenchyma. Pelvis renalis article about pelvis renalis by the free. In 1 case the diagnosis was confirmed by retrograde pyelogram. What is the meaning of left renal pelvis of bifid variety.
Hydronephrosis and upper urinary tract obstruction. The vast majority of renal cysts and benign simple cysts which are a symptomatic and causes no problems. Jan 12, 2016 the renal pelvis is the spot where the ureter joins the kidney. While i was there, they found blood in my urine and they did a ct scan and found that my ureter was dilated like i had a kidney stone, however, they didnt see one on the scan and i. Chapter 6 urinary system questions and study guide quizlet. Chapter 9 diagnostic and therapeutic procedures quizlet. It was also observed that both the ureter have different pattern of origin. A bifid ureter is present when there is a duplex kidney separate pelvicalyceal collecting systems draining into separate ureters, but the ureters unite before draining into the bladder at a single ureteric orifice 1. Duplex collecting system radiology reference article. However the hilum was present anteriorly and a bifid renal pelvis could be seen which was also malrotated. In comparison to a normal kidney with 89 calices, the duplex kidney consists of 1112 calices. What does it mean when a baby ultrasound shows a prominent. Makrina savvidou, h k dhillon, in twinings textbook of fetal abnormalities third edition, 2015. The american institute of ultrasound in medicine provides guidelines for a satisfactory examination 1.
The incidence for incomplete ureter duplication and a bifid renal pelvis duplication of pelvis of ureter is 4% in the north american population. The axis of each renal pelvis remains vertical or in the obliquely lateral plane. Major calyces are structures that are part of an extensive drainage system within each kid. Nonneoplastic disorders of the renal pelvis and ureter. The pelvicalyceal system showed ureteroureteral reflux into the blindending branch on photofluoroscopy and cineroentgenography. Bifid renal pelvis is a common anomaly and is considered a normal. One rare case of blindending branch originating in the upper third of the ureter.
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