Ureteral Polyp, Ureteropelvic Junction Obstruction vs. Intermittent Ureteropelvic Junction Obstruction
Left picture: The diagnosis is ureteropelvic junction obstruction due to a polyp, which leads as such to hematuria and to a changing dilatation of the renal pelvis. Notice the irregular filling defect at the lower end of the left pelvis and the longitudinal shape of the filling defect. Right picture: In this toddler an intermittent ureteropelvic junction obstruction is present due to an aberration of an artery of the lower renal pole. The hematuria is mainly generated by the renal pelvis, the dimensions of which is subject to acute and severe changes. Compare also the figure at the bottom in the same patient with a slender pyelocaliceal system in the IVU without fluid load and therefore, without symptoms and signs at this moment; and in the figure at the top of the same side, the smooth limits of the lower part of the renal pelvis and the ballooning of the whole system following fluid intake with consequent symptomatology as already described.
Left picture: IVU of a 13.5-year-old boy with recurrent hematuria and intermittent abdominal and flank colics. In contrast to the right kidney, the left renal pelvicocaliceal system is dilated. Right picture: IVU in a female toddler with sporadically observed and confirmed gross and microscopical hematuria and severe abdominal colics. In contrast to the right kidney in which the passage of contrast has already occurred, the left renal pelvis is dilated like a balloon.