Case Author(s): Tate Allen, M.D. and Farrokh Dehdashti, M.D. , 9/28/98 . Rating: #D2, #Q4

Diagnosis: Renal Duplication with Ectopic Ureterocele

Brief history:

Antenatal right hydronephrosis

Images:

Renal Scintigraphy

View main image(rs) in a separate image viewer

View second image(us). Right Renal Ultrasound

View third image(us). Bladder Ultrasound

View fourth image(fl). VCUG

Full history/Diagnosis is available below

Diagnosis: Renal Duplication with Ectopic Ureterocele

Full history:

This is a two-month-old female with a duplicated right kidney.

Radiopharmaceutical:

1.1 mCi Tc-99m MAG3 i.v.

Findings:

The renal scan shows normal perfusion to the kidneys. There is normal uptake and excretion by the left kidney and the lower pole of the right kidney. There is delayed uptake and no excretion of the radiopharmaceutical within the upper pole of the right kidney. This is constistant with obstruction of the upper pole. An ultrasound of the right kidney (second image) shows a dilated upper pole collecting system. The renal scintigram also has a large filling defect within the urinary bladder. An ultrasound of the bladder (third image) and a VCUG (fourth image) demonstrate this to represent an ectopic ureterocele.

Discussion:

Complete renal duplication is more common in girls than boys. The lower pole moiety inserts in the normal trigone location. The upper pole moiety inserts ectopically which is medial and caudal to the normal ureteric orifice. The is known as the Weigert-Meyer rule. The upper pole is often obstructed and is almost always associated with a ureterocele.

ACR Codes and Keywords:

References and General Discussion of Renal Scintigraphy (Anatomic field:Genitourinary System, Category:Normal, Technique, Congenital Anomaly)

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Case number: rs019

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