Nonoperative diagnosis of pyelocalyceal deformity due to venous impressions

Two patients with filling defects on films of the upper urinary tract caused by venous impressions are reported. To date, the literature includes 22 other cases. These cases are frequently associated with hematuria, flank or abdominal pain; the filling defect might be found incidentally during the evaluation of another problem. The two most frequent causes are varices--of renal vein, renal pelvic vein, ureteral veins, and normal renal vessels. Generally, the lesions were not diagnosed without surgical intervention. The filling defects of our cases were caused by other types of lesions. Their diagnosis was made nonoperatively through the use of intravenous pyelography, renal arteriography, and retrograde phlebography. Filling defects caused by venous impressions on the upper urinary tract should be diagnosed by the use of these three studies rather than surgically.