Case report: Echogenic necrotic renal papillae simulating calculi

Cheung, H. T. Andrew; Chan, Peter S.; Metreweli, C.

doi:10.1016/s0009-9260(05)80039-x

Cited by 3 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Like the cavities in renal papillary necrosis, pelvocaliceal diverticula may manifest as contrast materialfilled fluid collections adjacent to calices. However, these two entities can usually be distinguished on the basis of location: Pelvocaliceal diverticula are not found in papillae but, rather, adjacent to the caliceal fornices or, less commonly, to an infundibulum or the renal pelvis (5,(27)(28)(29)(30).…”

Section: Differential Diagnosismentioning

confidence: 99%

Renal Papillary Necrosis: Review and Comparison of Findings at Multi–Detector Row CT and Intravenous Urography

Jung

Kim

Jung³

et al. 2006

RadioGraphics

View full text Add to dashboard Cite

Renal papillary necrosis is not a pathologic entity but rather a descriptive term for a condition--necrosis of the renal papillae--that has various possible causes. The renal medulla and papillae are vulnerable to ischemic necrosis because of the peculiar arrangement of their blood supply and the hypertonic environment. The etiology of renal papillary necrosis includes diabetes, analgesic abuse or overuse, sickle cell disease, pyelonephritis, renal vein thrombosis, tuberculosis, and obstructive uropathy. Renal papillary necrosis has been diagnosed with the use of intravenous urography and ultrasonography, but contrast material-enhanced computed tomography (CT) may better depict a full range of typical features, including contrast material-filled clefts in the renal medulla, nonenhanced lesions surrounded by rings of excreted contrast material, and hyperattenuated medullary calcifications. In the presence of papillary sloughing, CT may depict hydronephrosis and filling defects in the renal pelvis or ureter, which also may contain calcifications. During healing, the epithelialized papillary tip appears blunted. Shrinkage of the kidney, a common sequela, also may be detected at CT. Multi-detector row CT depicts these and other features more clearly and directly than single-detector row CT, given the advantages of thinner sections and multiplanar reformation, and it may help identify the condition at an earlier stage, when effective treatment can reverse the ischemic process. Familiarity with the CT features of the condition therefore is useful for its successful diagnosis and management.

show abstract