[Computed tomography imaging in ureteropelvic junction obstruction--case report]

Area of Science:

• Urology
• Radiology
• Medical Imaging

Background:

• Ureteropelvic junction obstruction (UPJO) impedes urine flow, leading to pelvicalyceal system pressure, hydronephrosis, and renal parenchyma damage.
• Anomalous crossing vessels are a known cause of UPJO.
• Chronic abdominal pain and recurrent pyelonephritis can be symptoms of UPJO.

Observation:

• A 32-year-old female presented with chronic abdominal pain and a history of pyelonephritis.
• Contrast-enhanced computed tomography (URO-CT) revealed right pelvicalyceal system dilatation and UPJO.
• The obstruction was suspected to be caused by crossing vessels compressing the ureter.

Findings:

• URO-CT precisely identified the cause of UPJO, demonstrating the anatomical relationship between the ureter and crossing vessels.
• The diagnostic imaging allowed for surgical planning to decompress the pelvicalyceal system.

Implications:

• Contrast-enhanced URO-CT is valuable for diagnosing UPJ pathology, including identifying crossing vessels.
• Accurate diagnosis via URO-CT enables surgeons to select optimal surgical methods, minimizing risks like intraoperative bleeding from crossing vessels.