Pyelolymphatic backflow demonstrated on computed tomography urography in acute ureteric obstruction.

Authors

Ravi Jineshkumar Jain, Aman Kumar Jasuja, Sanjay Dhangar

Published in

BMJ case reports. Volume 19. Issue 10. Oct 06, 2026. Epub Oct 06, 2026.

Abstract

A man in his early 40s presented with acute right flank pain, vomiting and dysuria. Ultrasonography demonstrated an obstructing right upper ureteric calculus with a contralateral renal calculus. CT urography revealed fine, serpiginous contrast-opacified tubular channels extending from the right renal pelvis into the retroperitoneum without evidence of urinoma. Delayed excretory phase imaging demonstrated convergence towards the para-aortic region, consistent with pyelolymphatic backflow rather than collecting system rupture. The imaging pattern reflected markedly elevated intrarenal pressure and prompted urgent decompression. The patient underwent bilateral ureteric stenting followed by definitive endourological management with complete symptomatic resolution. Early recognition of this radiological entity prevents misdiagnosis and guides appropriate pressure-relieving intervention.

PMID:
42838702
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

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