Is this Kidney obstructed

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  • Dr. Anil Takvani
    Dr. Anil Takvani
    19 Mar 2021 10:53:09 PM

    Left ectopic kidney is obstructed. 

    Recurrent pain
    Lumpish palpation
    Increased CTT 
    Retention of redioisotope in kidney in delayed, erect posture plates 
    Last is drainage curve. 
    As it is ectopic/pelvic kidney I would wish to do VCUG but as ureter is not dilated and as there is no history of UTI, we can avoid it.

    Child needs pyeloplasty as an elective procedure. 

    By the way ectopic /pelvic position justified CECT else we would have avoided it. 


  • Gyanendra Sharma
    Gyanendra Sharma
    20 Mar 2021 10:16:39 AM

    I would agree with Anil

    Lump appearing & disappearing is S/O Dietl's crisis
    CTT is delayed
    I usually also ask for NORA which in my view is a better indicator of pelvic emptying then T 1/2 as it takes gravity into consideration
    Post micturition & erect images show retention of tracer which is a good indicator of delayed emptying of the pelvic
    This kidney looks obstructed and I would intervene in this patient

  • Lalit Shah
    Lalit Shah
    20 Mar 2021 11:44:41 AM

    Yes obstructed

    Surgery stat or reassessment after 6 months,would both be my option for the present. Informed shared decision after detail counselling would be decider.

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