PMC6815552_01
Kidney ultrasound scan showed severe right hydronephrosis with parenchymal thinning and normal left kidney.
CRIOG2019-9194615.001.jpg
PMC6815552_01_CRIOG2019-9194615.001.jpg
fig1
An ultrasound scan of the upper renal tract incidentally noted significant right hydronephrosis, with a renal pelvis anterior-posterior diameter of 42 mm and the presence of parenchymal thinning (Figure 1).
CT urogram confirmed significant right hydronephrosis with marked thinning of the renal parenchyma (a), and right hydroureter at the level of the pelvic brim where it crosses the common iliac artery (b).
CRIOG2019-9194615.002.jpg
PMC6815552_01_CRIOG2019-9194615.002.jpg
fig2
A CT urogram confirmed the significant right hydronephrosis with marked thinning of the renal parenchyma (Figure 2).
MAG3 scintigraphy showing complete loss of function of the right kidney.
CRIOG2019-9194615.003.jpg
PMC6815552_01_CRIOG2019-9194615.003.jpg
fig3
A MAG 3 scintigraphy showed that the right kidney was nonfunctional (Figure 3).
Right retrograde pyelogram showing a blind-ending right ureter at the level of the pelvic brim (a), where a wire could not be passed through the obstruction (b).
CRIOG2019-9194615.004.jpg
PMC6815552_01_CRIOG2019-9194615.004.jpg
fig4
Cystoscopy, right retrograde pyelogram (Figure 4) and ureteroscopy (Figure 5) showed a normal bladder, and a blind-ending right ureter compressed by a mass with purple discolouration at the level of the pelvic brim.
Ureteroscopy showing a blind-ending right ureter compressed by a mass with purple discolouration at the level of the pelvic brim.
CRIOG2019-9194615.005.jpg
PMC6815552_01_CRIOG2019-9194615.005.jpg
fig5
Cystoscopy, right retrograde pyelogram (Figure 4) and ureteroscopy (Figure 5) showed a normal bladder, and a blind-ending right ureter compressed by a mass with purple discolouration at the level of the pelvic brim.
MRI confirmed significant right hydronephrosis with marked thinning of the renal parenchyma (a), and right hydroureter (b).
CRIOG2019-9194615.006.jpg
PMC6815552_01_CRIOG2019-9194615.006.jpg
fig6
MRI confirmed the presence of gross right-sided hydronephrosis and hydroureter to the level of the pelvic brim, and the ureter was not visible below this point (Figure 6). Marked thinning of the right renal cortex was noted.
Laparoscopy revealed a dense 3 cm nodule over the right ureter at the pelvic brim involving the small bowel mesentery.
CRIOG2019-9194615.007.jpg
PMC6815552_01_CRIOG2019-9194615.007.jpg
fig7
Laparoscopy revealed a dense 3 cm nodule over the right ureter at the pelvic brim involving the small bowel mesentery (Figure 7).