Hydronephrosis Flashcards
Hydronephrosis
Aseptic dilatation of pelvi-calyceal system due to intermittent partial or complete blockade to the flow of urine
Unilateral hydronephrosis causes
Intaluminal causes
Intramural causes
Intraluminal causes of hydronephrosis
Renal stones ( acquired mc)
Sloughed papilla
Intramural causes
Congenital PUJ obstruction (mc congenital) this is a adynamic obstruction
Transitional cell carcinoma
( goblet or champange glass app)
Ureterocele (c in females)
Cobra head or adder head appearance
IOC in hydronephrosis of congenital PUJ obstruction
MSG 3 scan
Management of congenital PUJ obstruction
Anderson hynes dismembered pyeloplasty
Management of ureterocele
Resect the ureterocele
Reimplant the ureter
Endoscopic incision
Extraluminal causes of UL hydronephrosis
Abberebt renal vessels( ul)
(Mx– pyeloplasty)
Advanced cancers
(Recal, cervical, retropritoneal sarcomas)
Retrocaval ureter
Retroperitoneal fibrosis (ormond disease)
The sign in IVU in retrocaval ureter
Fish hook ureter or reverse J ureter
Mx in retrocaval ureter
Laterlize the ureter
Cut the segment behind IVC and do uretero ureterostomy
Causes of ormands disease
Idiopathic
Drug inducted
IGg4 mediated
Post radiotherapy
Drugs that givecrise to retroperitoneal fibrosis
Methysergide
Bromocriptine
First structures involved in retroperitoneal fibrosis
Ureter
Maidens waist deformity in IVU is seen in
Retroperitoneal fibrosis
Mx of retroperitoneal fibrosis
Steroids
D-J stents(double j)
