Asymptomatic young male ...

What should be offered ?

DTPA - LK 48%, RK 52%



  • Dr. Anil Takvani
    Dr. Anil Takvani
    29 Jan 2020 08:34:21 AM

    Thanks for posting this not an unusual case.

    Will not do anything other than observation.Points in favour;
    Patient is asymptomatic.
    This is dilated pelvicalyceal system but not proved to be because of obstruction.
    There is an excellent drainage in diuretic scan. His split function is in normal range.

    I have few queries;
    1. Why IVP + CT IVP? Was he investigate outside before presenting to you?
    2. Can you please provide sequential films of renal scan to get some idea of cortical transit time?

  • shriram joshi
    shriram joshi
    29 Jan 2020 11:26:19 AM

    This is congenital megacalycosis and not puj obstr.good drainage in all forms of imaging .

    Pelvis is partially intrarenal. The amount of calyceal diatation is disproportionate to almost normal looking pelvis. Lower ureter is filled and normal.
    These investigations have been duplicated giving unnecessary radition to a young male. Can't have IVU and CT ivu and nuclear medicine scan. Nuclear medicine scan and CT scan give total body radiation and are cummulative.
    Treatment nil. Just high fluid intake, watch for UTI and yearly follow up with USG.

  • Dr. Anil Takvani
    Dr. Anil Takvani
    29 Jan 2020 03:42:01 PM

    Shyam Joshi Sir thank you very much. 

    I missed the terminology 
    Congenital megacalycosis... 

  • Atul Kumar Khandelwal
    Atul Kumar Khandelwal
    29 Jan 2020 09:40:54 PM

    This is a case of congenital megacalycosis. It is mostly asymptomatic and discovered by accidentally or as a result of its complications like hematuria, infection and stone formation. Number of calyces is increased as compare to normal. Puigbert described first of this condition. No treatment is required for asymptomatic case. Annual follow up with USG is required.

    Atul Kumar Khandelwal

  • Tikenjit Mazumdar
    Tikenjit Mazumdar
    03 Feb 2020 02:30:00 PM

    One basic question sir ,how to read renogram systemically.

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