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Ureteropelvic Duplication

✅Ureteropelvic Duplications 👉The term ureteropelvic duplication refers to a broad range of anatomic variations ranging in severity from incomplete to complete. The incomplete form of duplication is more common than the complete form. With incomplete duplication, there can be a bifid renal pelvis, two ureters superiorly that join in midureter, or duplicated ureters that join just prior to insertion into the bladder wall. With complete duplication there are two completely separate ureters that have separate orifices into the bladder. Ureteropelvic duplication is thought to occur secondary to premature division or duplication of the ureteral bud. Such duplications are five times more common unilaterally than bilaterally. 👨🏽‍💻Collecting system duplication is the most common renal anomaly and may be partial or complete. The spectrum of partial duplication ranges from a bifid renal pelvis to Y-shaped ureters with the two ureters fusing somewhere along their course. A single common distal ureter enters the bladder. With complete ureteral duplication, the kidney has two pelvicalyceal systems and two ureters with separate insertions. Complete duplications are discussed in more detail later in the chapter. Partial duplication anomalies are generally not clinically significant and are found incidentally on sonography or CT. The nonobstructed duplex kidney is larger than the normal single system kidney and it has two separate renal sinus echo complexes on sonography and two renal pelvices on CT. Ultrasound Characteristics - 👩🏼‍💻On ultrasound, incomplete renal duplication may appear as an area of echogenicity similar to the renal cortex separating the echogenic central renal fat into superior and inferior components. Noncomplicated, incomplete renal duplications have little significance and should be thought of as a normal variation. Children with incomplete duplication are not at increased risk for urinary tract disease as compared to children without duplications. 👩🏾‍💻In patients with complete ureteropelvic duplication, there is a higher incidence of urinary tract infection, obstruction, vesicoureteral reflux, and parenchymal scarring. In these patients the ureteral orifice of the upper pole moiety inserts more medially and more inferiorly than the orifice of the lower pole ureter. This is known as the Weigert-Meyer rule. The lower pole system is more prone to vesicoureteral reflux and UPJ obstruction. The upper pole system is more prone to obstruction secondary to ureterocele. #beststudymaterial #bestpediatricsonographystudymaterial #pediatricsonography #ardms