Pediatric Radiology

, Volume 31, Issue 2, pp 120–124 | Cite as

Extrinsic ureteropelvic junction obstruction from a crossing renal vessel: demography and imaging

  • V. J. Rooks
  • R. L. Lebowitz
Original article

Abstract

Background. The increase in the use of prenatal ultrasound has revolutionized the detection of hydronephrosis and has had an unanticipated consequence.¶Objective. To describe the new demographics of symptomatic ureteropelvic junction (UPJ) obstruction and the characteristic imaging findings, when the obstruction is extrinsic, from a crossing renal vessel.¶Materials and methods. From a uroradiology database (1994 through 1999) we identified children with surgically corrected UPJ obstruction from intrinsic and extrinsic causes.¶Results. One hundred children had symptomatic UPJ obstruction treated by surgery. In 51 (49 %), obstruction was due to a crossing vessel. One hundred and one had UPJ obstruction detected by prenatal sonography. Only 11 (11 %) were due to a vessel. Two clinical and imaging findings were strongly suggestive of obstruction from a vessel: (1) in 5 of the 100 children the symptoms (pain, nausea, and vomiting) were intermittent. Only when symptoms were present were there hydronephrosis and obstruction; (2) in 51 of the 100 children a short segment of ureter, just below the UPJ, was filled with contrast or urine (on renal sonography, intravenous urography, or retrograde/antegrade ureterography).¶Conclusions. Extrinsic UPJ obstruction caused by a vessel is an uncommon cause of obstruction when all patients are considered. However, in symptomatic older patients whose hydronephrosis was not first identified on prenatal sonography, a vessel was the cause of obstruction in one-half.

Keywords

Characteristic Imaging Imaging Finding Hydronephrosis Short Segment Renal Sonography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • V. J. Rooks
    • 1
  • R. L. Lebowitz
    • 1
  1. 1.Children's Hospital and Harvard Medical School, Department of Radiology, 300 Longwood Avenue, Boston, MA 02115, USA Tel.: + 1-6 17-3 55 63 05 Fax: + 1-6 17-7 38 15 69US

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