Fraley syndrome is the eponymous term for a dilated calyx (hydrocalyx) due to compression of a calyceal infundibulum from an adjacent artery or vein.
On this page:
Epidemiology
It is a rare cause of obstruction of the collecting system. Involvement of an upper pole calyx is more common with the right side kidney being more regularly affected. Young women are more frequently sufferers.
Clinical presentation
The symptoms of Fraley syndrome can vary from asymptomatic microhematuria to severe, recurrent flank pain associated with infections and stone formation.
Radiographic features
Imaging findings include:
isolated distension and delay in emptying of a calyx (usually the right upper calyx)
well-defined horizontal filling defect in the infundibulum - best seen on MIP or 3D reformatted renal excretory phase
CT angiogram if performed tracks the vascular path over the kidney, demonstrating a vessel crossing the superior infundibulum and obstructing the superior calyces
Treatment and prognosis
In symptomatic patients, surgical correction is indicated. After identification of the artery responsible for the obstruction, the infundibulum is opened, uncrossed from the vessel, and closed by an end-to-end anastomosis.
Unable to process the form. Check for errors and try again.