Accuracy of antenatal fetal ultrasound in the diagnosis of duplex kidneys

Whitten, S. M.; McHoney, Merrill; Wilcox, Duncan T.; New, Susan A.; Chitty, Lyn S.

doi:10.1002/uog.40

Cited by 30 publications

(20 citation statements)

References 11 publications

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“…3 Detection of 2 separate poles or ureterocele are the strongest predictors of duplex renal units with predictive power of 93% and 78%, respectively. 4 Antenatal ultrasound with a duplex kidney may only show cystic dysplasia, leading to unclear differentiation between masses of renal and suprarenal origin.…”

Section: Discussionmentioning

confidence: 99%

Atrophic upper pole of a duplex collecting system masquerading as suprarenal mass: a case study and literature review

Kavanagh

McAuley

Longpre

et al. 2013

CUAJ

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The growing use of maternal fetal ultrasound is leading to the discovery of an increasing number of suprarenal masses. Our experience with a cystic suprarenal mass detected on antenatal ultrasound is described. Location and radiographic features could not rule out the possibility of a cystic neuroblastoma; therefore, surgical resection of the mass was performed. Despite the absence of common radiologic characteristics, the pathology of the specimen revealed a non-functioning upper pole of a duplex kidney with complete duplication of the collecting system. Neonatal evaluation and management and the differential diagnosis are discussed.Can Urol Assoc J 2010;4(4):E94-96 Case reportA routine second trimester ultrasound examination of a 28-year-old female (gravida 2, para 1) showed a well circumscribed, hypoechoic mass on the upper pole of the right fetal kidney. The mass measured about 6 cm in its largest diameter and appeared predominantly cystic in structure. The remainder of the detailed sonographic evaluation was unremarkable and no ureterectasis or ureterocele was observed. Size, echogenecity and structure of the mass remained unchanged throughout the pregnancy on repeated scans. An uneventful vaginal delivery at 38 weeks gestational age resulted in a female child with healthy Apgar scores.Postpartum examination of the neonate was completely normal, without palpable abdominal mass or lumbosacral abnormality. Abdominal ultrasound at 3 days demonstrated that the cystic structure remained unchanged in size and appeared contiguous with the upper pole of the kidney. The perinatal period was complicated with a simple, culture-positive urinary tract infection at 4 months, which was treated with oral cephalexin. The child was followed with serial ultrasounds at 3 month intervals during her first year of life (Fig. 1). Throughout this period, the cyst was noted to increase in size by a small amount (less than 1 cm in greatest diameter), but remained unchanged in echogenicity and structure. Renal size was comparable bilaterally throughout this period.At 11 months, the child was admitted to hospital with a second culture-positive urinary tract infection and treated with intravenous ampicillin and gentamicin. An ultrasound performed during her admission suggested that the cystic structure was more likely suprarenal in origin and displacing the right kidney. Subsequent imaging with a voiding cystogram was normal. A magnetic resonance imaging (MRI) scan at this time further suggested suprarenal origin of the cyst with compression and anterior displacement of the upper pole of the right kidney (Fig. 2). Neither hydroureter nor ureterocele was observed on MRI.Based on the location and radiologic appearance of the cyst, our differential diagnosis included simple renal cyst, duplex kidney and adrenal neuroblastoma. . Due to the inability to eliminate neuroblastoma from the differential diagnosis, the patient was referred to our centre for surgical resection of the mass at 15 months. Via a flank approach, we explored the ...

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Section: Discussionmentioning

confidence: 99%

Atrophic upper pole of a duplex collecting system masquerading as suprarenal mass: a case study and literature review

Kavanagh

McAuley

Longpre

et al. 2013

CUAJ

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“…In the present study 10 (66.7%) of the cases requiring an operation for a duplex renal system had abnormal prenatal ultrasound findings. In a study correlating prenatal scan findings with postnatal radiological investigations, Whitten et al reported the correct identification of a duplex renal system in 75% of cases11. In the latter series cases of duplex renal systems with normal prenatal ultrasound findings did not have postnatal urological work‐up, and the number of cases requiring surgery was not reported.…”

Section: Discussionmentioning

confidence: 99%

The sensitivity of antenatal ultrasound for predicting renal tract surgery in early childhood

Bhide

Sairam

Farrugia

et al. 2005

Ultrasound in Obstet & Gyne

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“…1 Stasis and infection may lead to stone formation in the lumen of the ureterocele and ureter, 2 with the stone assuming a ''cobra-head'' or ''hockey-stick'' shape. 3 Although endoscopic puncture or incision of an obstructed ureterocele is a wellestablished strategy for the pediatric population, 4 publications of a minimally invasive approach for ureterocele lithotomy are limited to those with minimal stone burden.…”

Section: Introductionmentioning

confidence: 99%

Voluminous “Cobra-Head” Stone in a Duplex System Ureterocele: Combined Cysto-ureteroscopic and Percutaneous Cystolithotomy Approach

Scuderi

Yankovic

Featherstone

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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We report a case of a 7-year-old boy with a voluminous 8.5-cm "cobra-head" calculus in a duplex system ureterocele causing flank pain, hematuria, and infection. Combined cysto-ureteroscopy and percutaneous cystolithotomy enables dependent ureterocele incision along its inferolateral border and efficient stone clearance in a single minimally invasive procedure. Protracted and repeated urethral instrumentation is avoided.

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Accuracy of antenatal fetal ultrasound in the diagnosis of duplex kidneys

Abstract: Objectives

Cited by 30 publications

References 11 publications

Atrophic upper pole of a duplex collecting system masquerading as suprarenal mass: a case study and literature review

Atrophic upper pole of a duplex collecting system masquerading as suprarenal mass: a case study and literature review

The sensitivity of antenatal ultrasound for predicting renal tract surgery in early childhood

Voluminous “Cobra-Head” Stone in a Duplex System Ureterocele: Combined Cysto-ureteroscopic and Percutaneous Cystolithotomy Approach

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