Presentation
Renal transplant about three months ago. Moderate hydronephrosis in the transplanted kidney was reported on follow-up ultrasonography.
Patient Data
By injecting the contrast medium through a nephrostomy catheter, the transplanted kidney is visualized in the left iliac fossa, with dilated collecting system and ureter. There is a mild focal stricture in the mid-ureteral level, and a severe segmental stricture evident in the distal part of the ureter.
No contrast medium leakage is evident and contrast medium finally passed in to the urinary bladder.
Case Discussion
Nephrostography is a special x-ray procedure that uses fluoroscopy to assess the renal collecting system by injecting water-soluble contrast through the nephrostomy catheter. It can be helpful to determine tube position, level of stenosis or assess residual stones in the upper collecting system.
This case demonstrates a patient with a recent renal transplant who reported moderate hydronephrosis in the follow-up ultrasonography. After contrast medium injection through a nephrostomy catheter, two mild and severe sites of ureteral strictures are visualized, which seems to be due to the surgical technique.
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