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Joseph Junewick, MD FACR
over 7 years ago
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Clot Pseudotumor

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: US CT
Activities:
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History

8 year old previously healthy male with hematuria after minor trauma.


Case Images


Diagnosis

Clot Pseudotumor

Clinical Notes

Follow up ultrasound 1 week later showed complete resolution.

Findings

CT – Collecting system lesion near the ureteropelvic junction predominantly isodense to muscle with a punctate central hyperdensity. Note the marked dilation of the right renal collecting system with thinning of the renal parenchyma.

US – Avascular solid and cystic mass appears adherent to the pelvic urothelium. Note the low level echoes within the collecting system.

Discussion

A kidney with a preexisting abnormality is at increased risk for injury. Trauma to an abnormal kidney occurs more frequently in children than in adults. Such injuries include disruption of the renal pelvis in ureteropelvic junction, hemorrhage or rupture of a renal cyst, rupture of a tumor, laceration of poorly protected ectopic or horseshoe kidney or infected kidney. Early complications occur within 4 weeks of injury and include urinary extravasation and urinoma formation, delayed bleeding, infected urinoma, perinephric abscess, sepsis, arteriovenous fistula, pseudoaneurysm, and hypertension. Late complications include hydronephrosis, hypertension, calculus formation, and chronic pyelonephritis.

Reference

Kawashima A, Sandler CM, Corl FM, et al. Imaging of Renal Trauma: A Comprehensive Review. Radiographics (2001); 21:557-574.



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