Abstract
IntroductionPelvo-ureteric junction obstruction and duplex kidney are common radiological findings. However, pelvo-ureteric junction obstruction in a duplex kidney is a rare finding. We present the case of a patient who presented with septic complications secondary to this combination.Case presentationAn adult woman presented with urinary sepsis, and her initial investigation with ultrasound revealed hydronephrosis of the lower moiety of a duplex kidney. Further investigations with computed tomography and magnetic resonance imaging showed an associated intrarenal abscess and a pelvo-ureteric junction obstruction of the lower moiety of a duplex kidney.ConclusionThis patient had a rare and unreported complication of an unusual congenital urological abnormality. This case report highlights the role of multiple imaging modalities in correct diagnosis for clinical management.
Highlights
Pelvo-ureteric junction obstruction and duplex kidney are common radiological findings
This patient had a rare and unreported complication of an unusual congenital urological abnormality. This case report highlights the role of multiple imaging modalities in correct diagnosis for clinical management
We present the case of a woman who presented with urinary sepsis secondary to an infected Pelvo-ureteric junction obstruction (PUJO) in the lower pole of a duplex kidney that was complicated by an intrarenal abscess
Summary
Pelvo-ureteric junction obstruction (PUJO) is a relatively common finding during urological investigation, as is duplex kidney. We present the case of a woman who presented with urinary sepsis secondary to an infected PUJO in the lower pole of a duplex kidney that was complicated by an intrarenal abscess. Ultrasound showed a hydronephrosis of the lower moiety of a duplex right kidney, and no cause could be identified. A magnetic resonance (MR) urogram (Figures 1 and 2) showed a wellcircumscribed, round lesion within the right lower pole cortex in addition to the lower moiety hydronephrosis. A subsequent microbiological analysis of the pus and urine showed no growth She had received 3 days of cefuroxime. A nephrostogram (Figure 3) performed several days later showed an incomplete duplex with the ureter joining at the pelvo-ureteric junction (PUJ). The patient remained asymptomatic 7 months later, and no further treatment is planned
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