Microscopical Hematuria and Urinary Tract Infection, Renal Trauma vs. Microscopical Hematuria and Urinary Tract Infection, Partial Hydronephrosis
Left picture: Here, a so-called upper calix syndrome (diverticulum of the calices) is present with a stenosis of the neck of the calices on the transition to the renal pelvis, and a dilatation of them due to a backflow. Notice the notch at the lateral renal contour. At the same time, the parenchymal thickness is the same in the upper pole as well as in the residual kidney. The history tells of a grade 3 blunt trauma to the kidney with a continuous fracture between upper pole and residual kidney which has been treated non-operatively. 1 3/4 year later, an upper calic syndrom due to the trauma of the pyelocaliceal system can be defined distinctly. Right picture: In this case, a mainly right-sided reflux nephropathy with dilatation of the upper caliceal group is present as consequence of the renal scars. Although no stenosis of the necks of the calices is present as in the contralateral picture, the partial hydronephrosis causes repeated microscopical hematurias and urinary tract infections due to a stasis of urine.
Left picture: IVU in a 3.1-year-old boy with microscopical hematuria and repeated urinary tract infections. The calices of the right upper pole are dilated without a corresponding dilatation of the renal pelvis. Right picture: IVU in a schoolchild with microscopical hematuria and recurrent urinary tract infections. The calices of the upper pole of the right kidney are dilated. Notice the size of the kidney and its parenchymal thickness which can barely be measured at the upper pole.