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Retroperitoneum » Kidneys, Ureters
Congenital uretero-pelvic junction obstruction
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Presentation A young man presents with right upper quadrant pain. An upper abdominal ultrasound was performed.
 
 
 
Caption: Sagittal view of right hypochondrium
Description: In place of the right kidney, a massively distended cystic appearing collecting system is seen. No clearly defined renal parenchyma is noted. A dilated ureter could not be demonstrated. This is consistent with congenital uretero-pelvic junction obstruction.
 
 
 
Caption: Transverse view of the right kidney
Description: The distended collecting system is noted again. No renal parenchyma can be identified, consistent with the atrophy due to long standing obstruction.
 
 
 
Caption: Transverse view of the left kidney
Description: The hugely distended right renal collecting system consisting of markedly dilated calyces and renal pelvis is noted again.
 
Differential Diagnosis Massive hydronephrosis with severe renal atrophy due to congenital uretero-pelvic junction obstruction
 
Final Diagnosis Massive hydronephrosis with severe renal atrophy due to congenital uretero-pelvic junction obstruction
 
Follow Up This patient underwent a right nephrectomy for the uretero-pelvic junction [UPJ] obstruction. The ultrasound findings of massive hydronephrosis with severe atrophy of renal parenchyma were confirmed. As expected there was no dilatation of the ureter.
 
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