Duplicated collecting system: Difference between revisions

Jump to navigation Jump to search
m (Bot: Automated text replacement (-{{SIB}} + & -{{EJ}} + & -{{EH}} + & -{{Editor Join}} + & -{{Editor Help}} +))
No edit summary
Line 1: Line 1:
__NOTOC__
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{PAGENAME}} |
   Name          = {{PAGENAME}} |
Line 9: Line 10:
   OMIM          = |
   OMIM          = |
   MedlinePlus    = |
   MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
   MeshID        = |
   MeshID        = |
}}
}}
{{SI}}
'''For patient information, click [[Duplicated collecting system (patient information)|here]]'''
{{Duplicated collecting system}}
{{CMG}}
{{CMG}}


'''Contributors:'''  [[User:zorkun|Cafer Zorkun]] M.D., PhD.
'''Contributors:'''  [[User:zorkun|Cafer Zorkun]] M.D., PhD.
==Overview==
==Overview==


Line 64: Line 61:
{{Reflist|2}}
{{Reflist|2}}
    
    
   
[[Category:Needs content]]
 
[[Category:Diseases]]
[[Category:Congenital disorders]]
[[Category:Congenital disorders]]
[[Category:Nephrology]]
[[Category:Nephrology]]

Revision as of 19:10, 28 September 2012

Duplicated collecting system
Duplicated collecting system.
Image courtesy of RadsWiki

For patient information, click here

Duplicated collecting system Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Duplicated collecting system from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

KUB X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Duplicated collecting system On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Duplicated collecting system

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Duplicated collecting system

CDC on Duplicated collecting system

Duplicated collecting system in the news

Blogs on Duplicated collecting system

Directions to Hospitals Treating Duplicated collecting system

Risk calculators and risk factors for Duplicated collecting system

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Contributors: Cafer Zorkun M.D., PhD.

Overview

Duplicated collecting system is the most common upper urinary tract anomaly, affecting nearly 15% of the population. [1] [2] [3]

Embryologically occurs when 2 separate ureteric buds arise from a single wolffian duct. The future lower pole ureter separates from Wolffian duct earlier and migrates superiorly and laterally as the urogenital sinus grows.

Weigert-Meyer rule for bladder insertion: the upper pole ureter inserts inferior and medial to lower ureter.

Alternatively, the 2 ureters may fuse to form a single ureter prior to inserting into the bladder, termed a bifid system.

The lower pole system is usually dominant, while the upper system may drain a single or few calices.

The upper pole ureter may demonstrate a ureterocele, which is associated with ureteral obstruction and recurrent UTIs in children. The upper pole ureter may also be ectopic or stenotic.

Symptoms

Diagnostic Findings

  • Excretory urography may demonstrate the duplicated anatomy. Limitation is that a poorly functioning system may not excrete contrast and may resemble a mass.
  • The drooping lily sign: inferolateral displacement of the opacified lower pole moiety in a duplex kidney from an obstructed (unopacified) upper pole moeity.
  • Voiding cystourethrogram is usually diagnostic and may demonstrate ectopic insertion and reflux.
  • Ultrasound is an easy, noninvasive exam that may show the duplex kidney and hydronephrosis. May not be able to differentiate between complete duplication and a bifid system.
  • CT urography may demonstrate the duplicated system and show the location of bladder insertion for each moiety.
  • MR urography may demonstrate the typical anatomic findings, but is an expensive alternative.
  • Renal scintigraphy can show the anatomy as well as evaluate for renal function.

Images courtesy of RadsWiki

References

  1. Glassberg KI, et al. Suggested terminology for duplex systems, ectopic ureters and ureteroceles. J Urol 1984; 132(6):1153-4.
  2. Callahan MJ. The drooping lily sign. Radiology. 2001 Apr;219(1):226-8.
  3. Sheth S and Fishman E. Multi-detector row CT of the kidneys and urinary tract: techniques and applications in the diagnosis of benign diseases. RadioGraphics 2004;24:e20.


Template:WikiDoc Sources