Duplicated collecting system: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Vishnu Vardhan Serla (talk | contribs)
nocaptcha
13,010 edits
No edit summary
Vishnu Vardhan Serla (talk | contribs)
nocaptcha
13,010 edits
No edit summary
Line 17: Line 17:


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


'''Duplicated collecting system''' is the most common upper urinary tract anomaly, affecting nearly 15% of the population. <ref>Glassberg KI, et al. Suggested terminology for duplex systems, ectopic ureters and ureteroceles. J Urol 1984; 132(6):1153-4.</ref> <ref>Callahan MJ. The drooping lily sign. Radiology. 2001 Apr;219(1):226-8.</ref> <ref>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.
==[[Duplicated collecting system historical perspective|Historical Perspective]]==
</ref>


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.
==[[Duplicated collecting system classification|Classification]]==


'''Weigert-Meyer rule''' for bladder insertion: the upper pole ureter inserts inferior and medial to lower ureter.
==[[Duplicated collecting system pathophysiology|Pathophysiology]]==


Alternatively, the 2 ureters may fuse to form a single ureter prior to inserting into the bladder, termed a bifid system.
==[[Duplicated collecting system causes|Causes]]==


The lower pole system is usually dominant, while the upper system may drain a single or few calices.
==[[Duplicated collecting system differential diagnosis|Differentiating Duplicated collecting system from other Diseases]]==


The upper pole ureter may demonstrate a [[ureterocele]], which is associated with ureteral obstruction and recurrent [[UTI]]s in children. The upper pole ureter may also be ectopic or stenotic.
==[[Duplicated collecting system epidemiology and demographics|Epidemiology and Demographics]]==


==Symptoms==
==[[Duplicated collecting system risk factors|Risk Factors]]==


*Most patients are symptomatic and are diagnosed as an incidental finding.
==[[Duplicated collecting system screening|Screening]]==
*[[Vesicoureteral reflux]]
*Recurrent UTIs, with resultant parenchymal scarring
*[[Ureteropelvic junction obstruction]]
*[[Hydronephrosis]], which may be severe enough to cause a palpable mass and hypertension
*Urinary incontinence with ectopic insertion in female


==Diagnostic Findings==
==[[Duplicated collecting system natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


*Excretory urography may demonstrate the duplicated anatomy. Limitation is that a poorly functioning system may not excrete contrast and may resemble a mass.
==Diagnosis==
*The '''drooping lily sign''': inferolateral displacement of the opacified lower pole moiety in a duplex kidney from an obstructed (unopacified) upper pole moeity.
[[Duplicated collecting system staging|Staging]] | [[Duplicated collecting system history and symptoms|History and Symptoms]] | [[Duplicated collecting system physical examination|Physical Examination]] | [[Duplicated collecting system laboratory findings|Laboratory Findings]] | [[Duplicated collecting system chest x ray|Chest X Ray]] | [[Duplicated collecting system CT|CT]] | [[Duplicated collecting system MRI|MRI]] | [[Duplicated collecting system other imaging findings|Other Imaging Findings]] | [[Duplicated collecting system other diagnostic studies|Other Diagnostic Studies]]
*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.


[http://www.radswiki.net Images courtesy of RadsWiki]
==Treatment==
[[Duplicated collecting system medical therapy|Medical Therapy]] | [[Duplicated collecting system surgery|Surgery]] | [[Duplicated collecting system primary prevention|Primary Prevention]] | [[Duplicated collecting system secondary prevention|Secondary Prevention]] | [[Duplicated collecting system cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |  [[Duplicated collecting system future or investigational therapies|Future or Investigational Therapies]]


<gallery>
==Case Studies==
Image:Duplicated-collecting-system-001.jpg|Duplicated collecting system
Image:Duplicated-collecting-system-002.jpg|Duplicated collecting system
</gallery>


==References==
[[Duplicated collecting system case study one|Case #1]]
{{Reflist|2}}
    
    
[[Category:Needs content]]
[[Category:Needs content]]

Revision as of 20:08, 30 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

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Duplicated collecting system from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging | History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Duplicated_collecting_system&oldid=762901"