21 Deviation of the Ureter

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GU 21-1 Hodgkin's lymphoma. Lateral displacement of both upper ureters, secondary to enlarged paracaval and para-aortic lymph nodes. Note also the splenomegaly and inferior displacement of the left kidney.4

• Fig GU 21-2 Retroperitoneal metastases from left testicular seminoma. Nephrotomogram shows lateral displacement of the proximal left ureter (arrowheads).4

• Fig GU 21-3 Aortic and common iliac aneurysms. Aortography faintly opacifies massively dilated vessels (arrowheads) because of contrast dilution. The deviated ureters typically follow the lateral borders of the aortic and common iliac artery aneurysms. The medial borders of the common iliac aneurysms are indicated (arrows).4

• Fig GU 21-4 Ureterosciatic hernia. Excretory urogram demonstrates a “horizontal curlicue” or horizontal looping of the left ureter in the region of the greater sciatic foramen (arrows).22

• Fig GU 21-5 Retroperitoneal fibrosis. Bilateral retrograde pyelogram shows dilatation of the collecting systems and ureters to the level of the L4-L5 disk space with medial deviation of the ureters.4

• Fig GU 21-6 Pelvic lipomatosis. Medial deviation of the ureters associated with mild distal ureteral obstruction. The characteristic pear-shaped bladder is elevated by perivesical fat.4

Fig GU 21-7 Bladder diverticulum. Medial displacement of the distal right ureter by the large diverticulum. Note the small left-sided diverticulum.4

• Fig GU 21-8 Cystocele. Coned view shows the medially displaced distal ureters compressed at the level of the levator sling (arrows). The ureterovesical junctions are several centimeters lower (arrowheads).4