Question

A delayed intravenous urogram of a patient is given below. What is the likely diagnosis?

• A. Pelviureteric junction obstruction
• B. Putty kidney
• C. Staghorn calculus
• D. Cystic kidney

Answer 1

The Correct Option is A

The delayed intravenous urogram of the patient shows features typical of a pelviureteric junction (PUJ) obstruction. PUJ obstruction occurs when there is a blockage at the junction where the renal pelvis meets the ureter, leading to a dilation of the renal pelvis and calyces, but the ureter remains normal in diameter below the obstruction. This condition is usually identified through imaging studies like an intravenous urogram (IVU) which demonstrate a distended renal pelvis (hydronephrosis) without a corresponding dilation of the ureter.
The options given are:

• Pelviureteric junction obstruction: Characterized by dilation of the renal pelvis and calyces with a narrow ureter below the point of obstruction.
• Putty kidney: Often associated with tuberculous infection leading to a calcified, non-functioning kidney.
• Staghorn calculus: Formed by large kidney stones taking the shape of the renal pelvis and calyces, leading to complex shadows in imaging studies.
• Cystic kidney: Associated with multiple cysts in the kidney, leading to an appearance distinct from obstruction or stones.

The features presented in the image and described in the question are consistent with Pelviureteric junction obstruction.