Dilated ureter

Given orally to pregnant rats at doses ranging from 5 to 50mg/kg body weight/day, purified pentachlorophenol produced dose-related signs of fetotoxicity, including resorptions, subcutaneous edema, dilated ureters, and anomalies of the skull, ribs, and vertebrae. "... 

K9 18 146 2 11.1 2 1.4 1 Aortic arch fused 2 Malpositoned subclavian artery, small lungs, malformed kidney, marked dilated ureters... 

Examine liver, gallbladder (mouse), stomach, spleen, pancreas, intestines, kidneys, adrenal gland, ureters, bladder, umbilical artery, genital organs, dorsal aorta, and caudal vena cava. Possible abnormalities that can be observed include absent renal papilla, dilated ureter(s), and displaced testis. 

Mouse (CD-1) 4dGd 11-15 1x/d 500 mg/kg/day (significantly increased incidence of cleft palate, dilated ureter and renal Zangaretal. 1989 coal tar... 

Hydronephrosis and dilated ureter in one fetus, hydrocephalus in another, and two fetuses with anophthalmia. 

In rats orally administered the compound cinnamaldehyde at doses of 5,25, or 250 mg/kg on days 7 to 17 of pregnancy, the incidence of poor cranial ossification was increased in all treated groups, while reduced ossification of the tympanic bulla was increased in the 25 and 250 mg/kg groups. Increases in the incidences of dilated pelvis/reduced papilla in the kidney, dilated ureters, and abnormal ster-nebrae were detected in the 25 mg/kg group, which had the highest overall prevalence of minor abnormalities. Increases in the incidences of reduced cranial ossification, dilated ureters, and renal variants were observed at 5 mg/ kg, a dose at which there was no detectable maternal toxicity (Mantovani et al. 1989). 

Fig. 1.83. Ureteropelvic junction obstruction. Longitudinal US scan of the right kidney demonstrates dilated calyces communicating with a markedly dilated renal pelvis (P). No dilated ureter is identified...

A contrast examination of the upper G1 tract may show dilated small bowel without peristaltic activity while on a colon enema a microcolon will he noticed (Fig. 5.10). US demonstrates a large urinary bladder with dilated ureters and pyelocaliceal systems. 

A basic study of the urinary tract should start with an explanation to the parents, and to the child if he or she is old enough to understand. The bladder is studied first, especially in infants, since reflex micturition is frequent when the transducer is placed on the abdominal wall (avoid unheated jelly). Examination of the full bladder includes analysis of urine echogenicity and the bladder wall. It is extremely important to look for dilated ureters(s) behind the... 

Fig. 5.7a-c. Megacalycosis and megaureter, a US sagittal scan ofthe left kidney. Unusual cystic dilatation of all the calyces. A lithiasis is visible at the lower pole, b US of the pelvis showing an associated dilated ureter (1.8 cm between crosses), c MR urography typical megacalycosis of the left kidney... 

Ureteral dilatation, or hydroureter, is a frequent cause of a dilatation of the fetal urinary tract. Under normal conditions, on fetal or postnatal US, the normal ureter is not visualized. Once it is visible (Fig. 5.20), a urinary tract dilatation is present and must be investigated (Keller and Weiss 1993). The presence of a dilated ureter may correspond to primary megaureter (MU), to refluxing MU (see Chap. 11), to nonobstructive nonrefluxing hydro-ureter, or to secondary hydroureter. The various imaging techniques will be necessary in order to differentiate between these entities. 

Fig. 5.20. Hydroureter Ultrasound. Left sagittal scan. A dilated ureter (U) is visible behind the bladder (B)...

Lee BR, Partin AW, Epstein JI et al (1992) A quantitative histological analysis of the dilated ureter of childhood. JUrol 148 1482-1486... 

Color Doppler US has been proposed as an adjunct to conventional US for the detection of VUR. First, the visualization of the ureteric jet by means of color Doppler US was thought to mean there was no VUR (Salih et al. 1994 Jecquier et al. 1990). Although it might be interesting to localize the ureteric orifices (Strehlau et al. 1997), other studies did not confirm this hypothesis. The use of color Doppler for the demonstration of VUR in dilated ureters has also been reported with VUR, the refluxing urine displays different colors related to the variable direction of flow. Unfortunately this can only be obtained when the ureters are dilated (Matsu mo et al. 1996). 

Renal pelvic dilatation can be defined as a kidney that on US examination has calyceal dilatation plus a dilated renal pelvis that measures greater than 10-15 mm in its AP diameter, and there is no associated US evidence of a dilated ureter. This is synonymous with pelvi-ureteric junction dilatation (PUJ), ureteropelvic dilatation (UPJ) and pelvicaly-... 

With a prenatal diagnosis of unilateral RPD, US examination should be undertaken about 48-72 h after birth to assess pelvic and calyceal dilatation, to both confirm the RPD and measure the transverse diameter of the pelvis, and to confirm that there is no dilated ureter and that the bladder and opposite kidney are structurally normal. If the US examina-... 

One must exclude VUR, and VCU is required. If VUR is found a Tc99m DMSA scan is required. If there is no VUR then diuretic Tc99m MAG3 renography is required. VUR on its own is neither sufficient nor necessary to cause renal damage in the context of UTI. When hydronephrosis is associated with a dilated ureter, VUR must be excluded. 

Fig. 13.9. Right UVJ obstruction. 3rd trimester. Transverse scan of the fetal abdomen. A circonvoluted dilated ureter (12 mm between the crosses) is visible. K, kidney B, bladder...

Fig. 13.12a,b. Duplex kidney with dilated upper pole and ectopic extravesical ureteral insertion, a Sagittal scan of the kidney with dilatation (D) of the upper pole and nondilated lower pole (LP).b Transverse scan ofthe fetal pelvis the dilated ureter (arrow) is visualized lateral the fetal uterus (U). Fb, fetal hack... 

Fig. 13.20a,b. MR imaging in complicated duplex kidney, a Left duplex with obstructed upper pole and ectopic intravesical insertion of the dilated ureter (arrow), b Left duplex with obstructed upper pole and ectopic ureterocele (arrow)... 

Fig. 17.3. Ultrasonographic demonstration of a large bladder (HB) with thin bladder wall and a dilated ureter in a newborn infant with prune belly syndrome...

The majority of dilated ureters less than 6 mm in diameter resolved, while 50% of those greater than 10 mm were treated with surgery. 

Hanna MK, Jeffs RD, Sturgess JM et al (1977) Ureteral structure and ultrastructure. III. The congenitally dilated ureter (megaureter). JUrol 117 24-27... 

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