Pyelosinus backflow of urine usually occurs through infractions of the calyceal fornices from obstruction or retrograde study. The primary cause appears to be a rapid rise in intrapelvic pressure with the backflow representing a physiologic release mechanism which returns the intrapelvic pressure to normal. Pyelosinus backflow is a benign process. However, complications can occur. In some persons whose urine transport cannot accommodate periodic increased urine flow or pressure, repeated pyelosinus backflow may lead to pseudocyst (urinomas) or retroperitoneal fibrosis. Several mechanisms produce these complications in children and adults. The authors present cases of urinomas related to upper tract obstruction from posterior urethral valves as well as ureteral obstruction by tumor, post-treatment scarring, retroperitoneal fibrosis, or calculus. Intrarenal urinomas are illustrated presumably in kidneys with firm capsular attachments to the renal pelvis which do not allow retroperitoneal extravasation.

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The radiologic manifestations of gastrointestinal edema observed as a complication of liver cirrhosis are described. We reviewed 22 consecutive patients with colonic and small bowel edema and present forms of intestinal involvement previously not reported. The pathophysiology of bowel edema is discussed and an attempt is made to correlate several factors. Our studies suggest that the production of intestinal edema is the result of a complex mechanism involving multiple factors on both sides of the capillary membrane. What appears crucial is not the absolute level of any disruptive force, but rather, the combination of several factors: 1. the ability of the lymphatic system to handle excessive flow; 2. the oncotic pressure; 3. the hydrostatic pressure and portal hypertension with or without venous collaterals. In this context, portal hypertension seems to play a dominant role since it correlates best with intestinal edema and explains its usual distribution.

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