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Urologic radiology

, Volume 10, Issue 1, pp 103–106 | Cite as

Fraley’s syndrome: Case report and update on current diagnostic methods

  • L. S. Zuckier
  • Y. D. Patel
  • E. J. Fine
  • M. Koenigsberg
Article

Abstract

A 38-year-old woman presented with fever, right flank pain, and a clinical diagnosis of pyelonephritis. Work-up revealed the presence of a crossing arterial branch causing obstruction of the superior infundibulum of the right kidney, which is an uncommon cause of nephralgia and urinary infection initially described by Fraley in 1966. Intravenous urography, retrograde pyelography, and angiography remain the mainstay of diagnosis, much as in the initial descriptions of this entity. [131I]Hippuran imaging, with analysis of the upper and lower pole regions of interest, provides a simple yet powerful method of evaluating functional and excretory changes in the superior infundibulum, and has proved more efficacious than previously reported whole-kidney renograms. Renal scintigraphy represents a relatively noninvasive method of serial functional examination in this disorder. Ultrasound imaging, by monitoring upper-pole dilatation, may provide complementary morphologic information important for long-term follow-up.

Key words

Fraley’s syndrome Hydronephrosis Kidney, radionuclide studies Kidney, US studies 

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References

  1. 1.
    Fraley EE: Vascular obstruction of superior infundibulum causing nephralgia. A new syndrome.N Engl J Med 275:1403–1409, 1966PubMedCrossRefGoogle Scholar
  2. 2.
    Benz G, Willich E: Upper calyx reno-vascular obstruction in children: Fraley’s syndrome.Pediatr Radiol 5:213–218, 1977CrossRefPubMedGoogle Scholar
  3. 3.
    Doppman JL, Fraley EE: Arteriography in the syndrome of superior infundibular obstruction. A simplified technic for identifying the obstructing vessel.Radiology 91:1039–1041, 1968PubMedGoogle Scholar
  4. 4.
    Fraley EE: Surgical correction of intrarenal disease. I. Obstructions of the superior infundibulum.J Urol 98:54–64, 1967PubMedGoogle Scholar
  5. 5.
    Fraley EE: Dismembered infundibulopyelostomy: improved technique for correcting vascular obstruction of the superior infundibulum.J Urol 101:144–148, 1969PubMedGoogle Scholar
  6. 6.
    Deckers PJ, Fraley EE, Paulson DF, Harbert JC: Vascular obstruction of the superior renal infundibulum in children.Surgery 67:856–862, 1970PubMedGoogle Scholar
  7. 7.
    Gold JM, Bucy JG: Fraley’s syndrome with bilateral infundibular obstruction.J Urol 112:299–301, 1974PubMedGoogle Scholar
  8. 8.
    Luciani L, Masini GC, Villari N, Muraro GB: Vascular impressions on the renal-collecting system: diuretic cineroentgenographic and angiographic study of 50 cases.Eur Urol 8:14–17, 1982PubMedGoogle Scholar
  9. 9.
    Harbert JC, Fraley EE: Scintillation camera renography in superior infundibular obstruction.JAMA 207:2433–2434, 1969CrossRefPubMedGoogle Scholar
  10. 10.
    Koyanagi T, Takamatsu T, Terashima M, Tsuji I: Intrarenal vascular obstruction of superior ureteropelvic junction causing nephralgia in a woman with complete duplex kidney.Int Urol Nephrol 10:267–274, 1978CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1988

Authors and Affiliations

  • L. S. Zuckier
    • 1
  • Y. D. Patel
    • 1
  • E. J. Fine
    • 1
  • M. Koenigsberg
    • 1
  1. 1.Departments of Radiology and Nuclear MedicineAlbert Einstein College of MedicineBronxUSA

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