PMC3761957_01
Antenatal ultrasonography of the fetal abdomen at 20.3 weeks of gestation: Transverse and parasagittal images depicting dilated left renal pelvis with AP dimension of 8.7 mm. (RK - Right kidney; LK - Left kidney; UB - Urinary bladder; TRANS - Transverse section; PARA SAG - Para sagittal section)
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F1
The left kidney of the fetus demonstrated dilated pelvis with antero-posterior (AP) dimension measuring 8.6 mm [Figure 1].
Follow-up ultrasonography approximatel 1 month later: Progressive increase in dilatation of the left renal pelvis with AP dimension of 19 mm. Note dilatation of calyces as well (white arrow) consistent with Society of Fetal Urology grade III hydronephrosis
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F2
AP dimension of pelvis measuring 19 mm along with dilatation of calyces (SFU grade III, Figure 2]. Amniotic fluid was normal in quantity.
Day 1 neonate: Note uniform distension of the upper abdomen in a crying neonate
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F3
The baby was slightly irritable with visible distension of the upper abdomen [Figure 3].
Day 1 ultrasonography: (a) Transverse section (5 MHz convex probe) of abdomen at the level of the renal hila. Note grossly hydronephrotic left kidney with dilated left renal pelvis reaching anterior to the right kidney across the spine (SP). The right kidney appears normal and (b) High-resolution image (10 MHz, linear probe) confirming the same findings
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F4
TR x CC, ~187 cc) extending across the midline to reach the right hypochondrium and flank [Figure 4]. The right kidney and urinary bladder were normal on USG.
DMSA scan: Posterior view depicting enlarged left kidney with markedly reduced tracer concentration and persistent excretion through the right kidney at 2 hr static image
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F5
A dimercapto succinic acid renal scan revealed enlarged left kidney with markedly reduced tracer concentration and persistent excretion through the right kidney [Figure 5].