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Case Reports
. 2018 Oct 30:2018:bcr2018227403.
doi: 10.1136/bcr-2018-227403.

Infected and obstructed kidney secondary to sloughed necrotic renal papilla

Michael G Fadel  1 , Mikaela Carey  1 , Marco Bolgeri  1
Affiliations
Case Reports

Infected and obstructed kidney secondary to sloughed necrotic renal papilla

Michael G Fadel et al. BMJ Case Rep. .
No abstract available

Keywords: diabetes; radiology; urological surgery; urology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Transverse views of CT abdomen/pelvis scan (with intravenous contrast). The CT revealed mild left-sided hydroureteronephrosis with extensive perinephric stranding with no other cause for these findings (A). There is also possible posterior bladder wall thickening near the ureteric orifice and left distal ureteric enhancement can be seen (B). This was concerning for a possible focal bladder or distal ureteric lesion. A urographic phase was not performed, therefore, specific sloughed papilla findings are difficult to comment on.
Figure 2
Figure 2
Coronal views (A and B) of CT abdomen/pelvis scan (with intravenous contrast) demonstrating the infected and obstructed left collecting system and dilatation of the intramural ureter. The parenchyma of the left kidney is normal and no urinary tract calculi can be seen.
Figure 3
Figure 3
Cystoscopic view (A) of sloughed renal papilla that was seen protruding from the left distal ureteric orifice, which was subsequently removed (B) (firm yellow tissue measuring 9×6×4 mm).
Figure 4
Figure 4
Following removal of the sloughed renal papilla, a ureteric stent (6 French/22 cm) was inserted for relief of the obstruction.
Figure 5
Figure 5
Biopsy taken from the left kidney (A and B) showing necrotic and infarcted tissue (no nuclei are apparent) with ‘ghost’ outlines of renal papillae elements. No malignancy identified (H&E stain, 40x).
See this image and copyright information in PMC

References

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    1. Jung DC, Kim SH, Jung SI, et al. . Renal papillary necrosis: review and comparison of findings at multi-detector row CT and intravenous urography. Radiographics 2006;26:1827–36. 10.1148/rg.266065039 - DOI - PubMed
    1. Kamath S, Moody MP, Hammonds JC, et al. . Papillary necrosis causing hydronephrosis in renal allograft treated by percutaneous retrieval of sloughed papilla. Br J Radiol 2005;78:346–8. 10.1259/bjr/12933217 - DOI - PubMed

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