Ureteropelvic junction obstruction

  • Congenital seen in 1 in 500 live births
  • Intrinsic narrowing of proximal ureter as it joins pelvis
  • Congenital disruption of muscle development
  • In 10% cases, aberrant or accessory renal artery crosses and obstructs proximal ureter
  • Antenatal hydronephrosis detection
  • Abdominal mass
  • Intermittent flank pain
  • Voiding cystourethrogram is used to rule out reflux disease
  • Diuretic renography – DTPA or MAG3. Shows delayed radio tracer washout in obstructed system. Split function calculations help plan the need of any surgical intervention
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Lawler, Leo P., et al. “Adult Ureteropelvic Junction Obstruction: Insights with Three-dimensional Multi–Detector Row CT.” Radiographics 25.1 (2005): 121-134.

Rouvière, Olivier, et al. “Ureteropelvic junction obstruction: use of helical CT for preoperative assessment—comparison with intraarterial angiography.” Radiology 213.3 (1999): 668-673.