Rosanna Fragante, MD
Fat
S = Suprarenal glands (aka the adrenal glands)
A = Aorta/IVC
D = Duodenum (second and third segments [some also include the
fourth segment] )
o P = Pancreas (tail is intraperitoneal)
o U = Ureters
o C = Colon (only the ascending and descending parts)
o K = Kidneys
o E = Esophagus
o R = Rectum
kidneys are located within the cone of renal fascia (Gerota fascia),
surrounded by the fat of the perirenal space
o
o
o
o
TOPIC OUTLINE
I.
Retroperitoneum
II.
KUB Imaging
A. Intravenous pyelography
B. Ultrasound
C. CT/MRI
D. CT Angiography
E. CT Stonogram
F. CT Urogram
URETER
3 mm thin, can collapse
1 cm diameter and 25 cm long
Three narrowings:
o
Junction of ureter and renal pelvis (ureteropelvic junction)
o
Where it crosses the brim of the pelvic inlet
o
Passage through the wall of urinary bladder (ureterovesicular
junction)
Inflammation/Infection
A. Pyelonephritis
B. Renal Abscess
C. GU Tuberculosis
A. Renal Trauma
B. Bladder trauma and extrophy
VIII. Calculi
A. INTRAVENOUS PYELOGRAPHY
B. Urolithiasis
C. Cystolithiasis
B. Renal Cell CA
C. Transitional Cell CA
X. Renal Angiography
XI. Adrenal Glands
XII. Prostate and Scrotum
XIII. Uterus and Adnexa
I. RETROPERITONEUM
No radiation
Real-time
Can distinguish between solid and cystic structures
Can be used as a guide in biopsy
Jayson, Paosee
Page 1 / 10
Jayson, Paosee
Page 2 / 10
o
o
Nephrolithiasis
Wilms tumor, TCCA
ureteropelvic
junction
vesicoureteral reflux and decreased function
obstruction,
D. HORSESHOE KIDNEY
Most common fusion anomaly
Complications:
o Trauma
o Calculi
o Transitional cell CA
Prone to
Jayson, Paosee
Page 2 / 10
Bosniak I
Fluid inside is clear
50% of population greater than 50 years
Tubular diverticula which detach and filled with fluid
Thin walls
No solid component
Fig. 15. Polycystic Kidney Disease
Jayson, Paosee
Page 2 / 10
Fig. 18. Renal abscess (A) with thick walls and and
septations.
C. GU TUBERCULOSIS
Jayson, Paosee
Fig. 19. KUB Film (left) and CT Scan (right) with foci of renal
tuberculosis, shown by white arrows. Multiple calcific
densities are seen. In the ureter, there are stones. CT scan
(upper right) shows presence of multiple granuloma in the
liver (possible source of genitourinary TB)
VI. URINARY BLADDER
A. PROSTATOMEGALY
Page 2 / 10
Jayson, Paosee
A. RENAL TRAUMA
Injury to the kidney may lead to hemorrhages at the perirenal
region
If patient presents with flank pain, perform CT and assess the
extent of the hematoma
Reperfusion may be done but patient must be observed first.
Temporize if the BP does not go low.
Page 2 / 10
Jayson, Paosee
Page 2 / 10
B. RENAL CELL CA
Jayson, Paosee
Page 2 / 10
X. RENAL ANGIOGRPAHY
A. RENAL ARTERY STENOSIS
Jayson, Paosee
Page 2 / 10
Jayson, Paosee
Page 2 / 10
C. TESTICULAR TORSION
Jayson, Paosee
Page 2 / 10
Jayson, Paosee
Page 2 / 10
Fig. 51. Normal placenta: high lying and with normal blood flow
in Doppler sonography
Jayson, Paosee
Page 2 / 10
Jayson, Paosee
Page 2 / 10