Detection of ureterocele in distal ureteric stump following nephrectomy on diuretic renal scan and SPECT/CT

Document Type : Case Report

Authors

Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

A 10 years old girl with complain of hematuria and recurrent febrile urinary tract infection (UTI), with a history of bilateral vesicoureteric reflux (VUR) leading to nephrectomy as a result of a non-functional left kidney 3 yrs previously , was referred to our department for diuretic renal scan. The study showed normal function of the right kidney, normal excretion of the tracer from pyelocalyceal (PC) system, along with a small ibsilateral cortical defect. No active renal tissue was noted on the left side. Post void images showed a collection of activity on the left side of the bladder. The SPECT/CT also demonstrated this collection of activity on the same region compatible with post nephrectomy distal ureteral stump. Our case study revealed the diuretic renal scan can be of help in detection of ureterocele in post nephrectomy remained distal ureteral stump which might present with symptoms such as pain and hematuria. In addition our case underscores the importance of SPECT/CT for reaching a correct diagnosis in these patients.

Keywords

Main Subjects

References

  1. Taylor AT, Brandon DC, de Palma D, Blaufox MD, Durand E, Erbas B, Grant SF, Hilson AJW, Morsing A. SNMMI Procedure Standard/EANM Practice Guideline for Diuretic Renal Scintigraphy in Adults With Suspected Upper Urinary Tract Obstruction 1.0. Semin Nucl Med. 2018 Jul;48(4):377-90.
  2. Shariati F, Dabbagh Kakhki VR, Sadeghi R. Urinary reflux to the non-functioning previous renal graft. Iran J Nucl Med. 2012;20(2):41-43.
  3. Arora S, Yadav P, Ansari MS. Diagnosis and management of symptomatic residual ureteral stump after nephrectomy. BMJ Case Rep. 2015 Feb 26;2015:bcr2015209441.
  4. Androulakakis PA, Stephanidis A, Antoniou A, Christophoridis C. Outcome of the distal ureteric stump after (hemi)nephrectomy and subtotal ureterectomy for reflux or obstruction. BJU Int. 2001 Oct;88(6):586-9.
  5. Biswas K, Singh AG, Ganpule AP, Sabnis RB, Desai MR. Clinical features and management of ureteric stump syndrome: Single-centre experience and contemporary literature review. Asian J Urol. 2022 Apr;9(2):193-6.
  6. Taylor AT. Radionuclides in nephrourology, part 1: Radiopharmaceuticals, quality control, and quantitative indices. J Nucl Med. 2014 Apr;55(4):608-15.
  7. Katsui M, Iwasawa T, Kitaoka S, Hideki O, Hattori S, Hara S. Pure laparoscopic total ureterectomy for urothelial carcinoma that occurred in the ureteral stump after nephrectomy: A case report. Urol Case Rep. 2021 Feb 26;37:101618.
  8. Narayana C, Tripathi M, Kumar A, Gowda NK, Phom H, Chandra P, Bandopadhyaya G, Bal C. Technetium-99m-L,L-ethylenedicysteine renal scan as a single-modality investigation for the evaluation of renal morphology and function: a comparative study with technetium-99m-dimercaptosuccinic acid. Nucl Med Commun. 2004 Jul;25(7):743-7.
  9. Lin CC, Shih BF, Shih SL, Tsai JD. Potential Role of Tc-99m DTPA Diuretic Renal Scan in the Diagnosis of Calyceal Diverticulum in Children. Medicine (Baltimore). 2015 Jun;94(24):e985.
  10. Shubha AM, Das K. Retaining the refluxing lower ureteral stump of a non-functioning kidney to preserve contralateral renal function. J Pediatr Urol. 2015 Jun;11(3):150.e1-6.

Files

Share

How to cite

Statistics