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Lower moiety pelvic-ureteric junction obstruction (PUJO) of the duplex kidney presenting with pyonephrosis in adults

Department of Radiology, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK

View larger version (115K): [in a new window]   Figure 1. Acute intravenous urography shows a left duplex kidney with a hydronephrotic lower moiety.

View larger version (102K): [in a new window]   Figure 2. Ultrasound shows a left duplex kidney with marked hydronephrosis of the lower moiety.

View larger version (90K): [in a new window]   Figure 3. Antegrade study reveals a dilated pelvicalyceal system and renal pelvis with a narrow pelvic-ureteric junction and slender ureter. The appearance is of a pelvic-ureteric junction obstruction of the lower moiety left duplex kidney.

View larger version (35K): [in a new window]   Figure 4. (a, b) Dynamic MAG-3 renogram indicates minimal renal function in the left lower moiety.

View larger version (133K): [in a new window]   Figure 5. Acute intravenous urography shows a left duplex kidney with hydronephrotic lower moiety.

View larger version (112K): [in a new window]   Figure 6. Ultrasound examination shows a hydronephrotic lower moiety containing internal echoes (immediately prior to ultrasound guided nephrostomy insertion).

View larger version (174K): [in a new window]   Figure 7. Antegrade study shows the presence of a hydronephrotic lower moiety with pelvic-ureteric junction obstruction.