Lesson 4A (Part 4) Flashcards
What does supernumerary kidney look like on US?
An extra kidney will be found
- usually smaller
Where is the supernumerary kidney located?
Found above, below in front of or behind the normal kidney
What is the most common congenital anomaly?
Duplex collecting system
Duplex collecting system
Two separate collecting systems, ureters and their own ureteral orifice
Where do the ureters join and enter the bladder with an incomplete duplication?
Through a single ureteral orifice
What do patients of an increase risk of with a incomplete duplication?
Increased incidence of UPJ obstruction and uterus didelphys-duplex uterus
Incomplete duplication
Ureter draining the lower pole has a more perpendicular course through the bladder wall
What are you more prone to with an incomplete duplication? (2)
- Reflux
2. Obstruction
What does obstruction of the ureter result in?
Cystic dilation of the intramural portion of the ureter
What does cystic dilation of the intramural portion of the ureter give rise to?
Ureteroceles
What are ureteroceles prone to?
Ureteral obstruction
- UTI’s
What is the treatment for ureteroceles?
Surgical
How do ureteroceles appear on US?
Round cyst like structure in the bladder
What does colour doppler do with ureteroceles?
Assess both jets
What may be present in the upper poles of ureteroceles?
Hydronephrosis
What is a common anomaly that causes a kink?
Ureteropelvic junction obstruction
- UPJ
Who is UPJ more common in?
Men
What happens with UPJ obstructions? (3)
- Stones
- Infection
- Impaired renal function
What are 3 anomalies of bladder development?
- Bladder agenesis
- Bladder duplication
- Bladder exstrophy
Bladder agenesis
No bladder
How are more infants with bladder agenesis?
Stillborn
What gender is more likely to survive bladder agensis?
Females
What are the 3 types of bladder duplication?
- Complete/incomplete peritoneal fold separates 2 bladders
- Complete/incomplete septum divides bladder
- may be multiple septa - Transverse band of muscle divides the bladder into 2 unequal parts
Bladder Exstrophy
Congenital absence of lower abdominal and anterior bladder wall
What increases with bladder exstrophy?
The incidence of bladder carcinoma
Aberrant vessels
During embryology, the kidney receives blood from the higher levels of the Aorta
When will aberrant renal arteries be present?
If supply from lower levels persist
Who is retrocaval ureter more common with?
Males
Retrocaval ureter
If the infrarenal IVC does not develop from the usual Supracardinal vein, the ureter will pass posterior to the IVC
- may become compressed as the ureter takes an unusual path before entering the bladder
How can urachal anomalies present as? (5)
- Patent
- associated with urethral obstruction - Cyst
- urachus closes at umbilical and bladder ends - Sinus
- closes at bladder, patent at umbilicus - Abscess in the abdominal wall
- may form in the abdominal wall arising from the urachus - Diverticulum
- closes at umbilicus,open at bladder
Who is urachal anomalies more common with?
Males
Where is urachal anomalies located?
Between the umbilicus and the bladder
What increases with urachal anomalies?
Incidence of carcinoma and stone formation
