Summary

hugely dilated renal pelvis, a case study of PUJ obstruction

Imaging of severe left PUJ obstruction shows the left kidney not visualized on ultrasound and a 15 cm cyst in the left renal fossa. CT reveals severe hydronephrosis, thinning of the cortex with only 2 to 4 mm of functional parenchyma, and a non-functional kidney. Radionuclide scan confirms reduced perfusion and delayed drainage. Etiologies include congenital stenosis, aberrant vessels, and acquired scarring. Prognosis is poor, risking renal failure and infections. Management involves surgical intervention (pyeloplasty, nephrectomy) and follow-up. Differential diagnoses include multicystic dysplastic kidney, renal cystic disease, renal abscess, cystic renal cell carcinoma, and severe hydronephrosis from ureteral obstruction.

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