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Ureteropelvic junction obstruction in lower pole moiety of duplex kidney

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Left loin pain

Patient Data

Age: 25 years
Gender: Female

Cystic mass at lower pole of left kidney

Delayed 20 minutes post-injection of contrast, imaged supine and prone.

Duplex left collecting system with a ureteropelvic junction (UPJ) obstruction in the lower pole moiety - no ureter identified in the lower pole.  Non-filling of lower pole ureter even in the prone position.

Pre-operative MAG3 nuclear renogram: delayed filling and emptying of left lower pole moiety.

Post-pyleoplasty MAG3 renogram: filling and emptying of left lower pole moiety much improved after Lasix injection.

Post pyeloplasty MAG3 statistics: note rapid clearance from left kidney post-Lasix injection at 22 minutes

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