Symptom of renal pelvic “pseudodissection” with computed tomography as a sign of pyelosinus reflux and urine extravasation
https://doi.org/10.24835/1607-0763-1145
Abstract
The purpose of the study. To find typical computed tomographic signs of pyelosinus reflux with a small amount of extravasation of urine.
Material and methods. Eight observations were analyzed in which there was extravasation of urine into the renal sinus detected by CT.
Results. In six cases, the changes were on the right, in two – on the left side. The cause of acute urinary tract obstruction in four cases were ureteral stones, in two cases there was compression of the ureter from the outside by a pelvic tumor. In two cases, a day after the relief of renal obstruction, the contrasted urine outside the pelvic was not determined. Additional findings were: flection of the ureter in two cases, renal sinus cysts – in four observations. In four observations an unusual “pseudodissection” of the renal pelvis in the excretory phase was revealed, which consisted in the presence of a thin non-contrasting layer "dividing" the contrasted contents of the pelvis into two parts.
Conclusions. 1. Identification of the pattern of “pseudodissection” of the pelvis is practically a pathognomonic computed tomographic symptom of extravasation of urine as a result of pyelosinus reflux and rupture of renal calices. 2. Resolution of ureteral obstruction can lead to complete normalization of the computed tomographic picture during the day. 3. Inflection of the ureter, cysts of the sinus of the kidney, may be provoking factors of extravasation of urine in acute ureteral obstruction, but this requires further study.
About the Authors
A. I. Gromov
Clinical hospital No.2 of “MEDSI group” Joint Stock Company; GKB named of V.M. Buyanov
Russian Federation
Competing Interests:
Russian Federation
Alexander I. Gromov – Doct. of Sci. (Med.), Professor, Medical Stomatological University named of A.I. Evdokimov. Head of the Department of Radiology of the Clinical Hospital 2 of the MEDSI Group of Companies
12528, Moscow, Botkinsky proezd, 5-3
Competing Interests:
The authors declare no conflict of interest.
Y. V. Sidorova
Clinical hospital No.2 of “MEDSI group” Joint Stock Company
Russian Federation
Competing Interests:
Russian Federation
Yulia V. Sidorova – Cand. of Sci. (Med.), Radiologist, Radiology Department
125284, Moscow, 2-nd Botkinsky pr., 5-3, 4
Competing Interests:
The authors declare no conflict of interest.
E. V. Novoselova
GKB named of V.M. Buyanov
Russian Federation
Competing Interests:
Russian Federation
Elena V. Novoselova – Radiologist, Radiology Department
115516, Moscow, Bakinskaya str., 26
Competing Interests:
The authors declare no conflict of interest.
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For citations:
Gromov A.I., Sidorova Y.V., Novoselova E.V. Symptom of renal pelvic “pseudodissection” with computed tomography as a sign of pyelosinus reflux and urine extravasation. Medical Visualization. 2022;26(2):130-138. (In Russ.) https://doi.org/10.24835/1607-0763-1145
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