July 15, 2012

Intravenous Urogram: Non Functioning Left Kidney

A 30 years old lady first presented with left flank pain, fever with chills and rigor and lethargy. An ultrasound of the KUB system shows left kidney hydronephrosis with dilatation of pelvicalyceal system and debris with layering of low level echogenic foci. She was then proceed with CT scan and a diagnosis of left kidney pyonephrosis with left ureterolithiasis was made. 

Left kidney percutaneous nephrostomy done and drains 500 cc of pus. 28 days later, she was planned for stenting to relieve the obstruction but failed as the catheter are unable to get through. An IVU was then performed which shows feature of non functioning left kidney and she was subjected for left nephectomy.

A Preliminary control film shows presence of left percutaneous nephrostomy tube in situ with distal left ureterolithiasis

After 5 minutes, the right pelvicalyceal system shows enhancement with contrast while the left kidney did not shows any contrast enhancement.

Unequal pyelogram phase

There is prompt excretion of contrast on the right kidney. The contrast drains well through the right ureter.

the contrast drains into the urinary bladder

The bladder fills with contrast

post micturation film

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