IMAGE OF THE WEEK

WEEK 3

 

 

   

Duplex Kidney with Reflux

 

Duplex kidney is a not uncommon condition, which is bilateral in between 15-40%.  The upper pole moiety is often subject to obstruction and is associated with an ectopic ureterocele.  The lower pole moiety tends to be subject to vesicoureteric reflux.  Higher grades of reflux (III, IV & V) are associated with reflux nephropathy, resulting in an atrophic, poorly functioning kidney and hypertension if left uncorrected and require surgical correction. (Arrows: duplex/double pelviureteric junction, arrow heads: dilated ureters)

 

 

International Grading of Vesicoureteric Reflux

 

 

Grade I

Reflux up into the ureter only.

Grade II

Reflux up into a non-dilated ureter and also into a non-dilated pelvicaliceal system.

Grade III

Reflux up into a mildly dilated ureter and pelvicaliceal system. The papillary impressions remain intact and distinct.

 Grade IV

Reflux up into a tortuous dilated ureter and dilated pelvicaliceal system. The forniceal angles are blunted while the papillary impressions remain distinct.

 

 

Images prepared by Dr Ian Bickle, Consultant Radiologist, RIPAS Hospital, Brunei Darussalam.

All images are copyrighted and property of RIPAS Hospital.

 

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