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Chapter-60 Urologic Imaging

BOOK TITLE: Kidney & Pancreas Transplantation

Author
1. Molmenti Ernesto P
2. Volpacchio Mariano
3. D’Agostino Catherine
4. Palestro Christopher
5. Hamilton W Mark
6. Warshawsky Robin J
7. Nagata David
8. Rodrigo Maximiliano de
9. Pellerito John
ISBN
9789351523390
DOI
10.5005/jp/books/12547_61
Edition
1/e
Publishing Year
2015
Pages
14
Author Affiliations
1. Hofstra Northwell School of Medicine, Long Island, New York, USA, North Shore-LIJ Health System, Long Island, New York, USA; Hofstra North Shore–LIJ School of Medicine, Long Island, New York, USA
2. Hospital de Clinicas Jose de San Martin, Universidad de Buenos Aires; Centro de Diagnostico, Dr. Enrique Rossi, Buenos Aires, Argentina
3. North Shore-LIJ Health System; Body Imaging Fellowship Program; Hofstra North Shore-LIJ Health System, Hempstead, New York, USA, North Shore-LIJ Health System; Hofstra North Shore-LIJ Health System, Hempstead, New York, USA
4. North Shore-LIJ Health System; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
5. Baylor University Medical Center, Dallas, Texas, USA
6. North Shore-LIJ Health System, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
7. Internal Medicine, St. Luke’s Fruitland Clinic, Fruitland, Indiana, USA
8. Hospital Interzonal General de Agudos, “Dr. Oscar Alende” (HIGA), Esophageal and Gastric Surgery, Mar del Plata, Argentina
9. North Shore-LIJ Health System; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
Chapter keywords
urinary obstructions, ureterovesical junction, distal transplant ureter, antegrade pyelograms, dilatation

Abstract

Most of urinary obstructions occur at the ureterovesical junction or in the distal transplant ureter. In the immediate postoperative period, obstructions are usually associated with: tight anastomosis, torsion/twisting of the ureter, edema and blood clots. Nuclear scintigrams may show clearance of the radiotracer. Antegrade pyelograms not only can diagnose obstructions, but also show the site and type of stenosis and may be used as a guide to percutaneous treatment. Ultrasound images should be interpreted with caution as dilatation of the collecting system may be absent in early stage. Dilatation of the transplant ureter and collecting system may be due to reflux from a full bladder. Dilatation may persist from previous instances of treated obstruction.

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