Question
Identify the procedure:
| A. |
Retrograde pyelogram |
| B. |
Combined retrograde pyelogram and ureteroscopy |
| C. |
Intravenous pyelogram |
| D. |
Antegrade pyelography |
|
Correct Answer � C Explanation |
 |
The image shows bilateral visualization of kidneys, ureters, and bladder (KUB system) after contrast injection. Contrast fills from kidneys downward through ureters into bladder, outlining the urinary tract descendingly.
This pattern is characteristic of an Intravenous Pyelogram (IVP), also called Intravenous Urography (IVU).
In IVP:
– Contrast dye is injected intravenously.
– Kidneys filter it, outlining renal calyces, pelvis, ureters, & bladder.
– Serial X-rays track contrast passage over time.
IVP evaluates:
– Renal stones
– Hydronephrosis
– Ureteric obstruction
– Structural anomalies
– Hematuria workup
Symmetrical contrast in both ureters and bladder, with no lower tract instrumentation, supports a non-invasive, systemic contrast route.
Why Other Options Are Incorrect:
A. *Retrograde Pyelogram:* Contrast injected directly into ureters via cystoscope. Invasive. Typically outlines one ureter at a time unless bilateral catheters used. Contrast flows upward (bladder → ureter → renal pelvis). Catheter/stent shadows appear in lower tract, absent here.
B. *Combined Retrograde Pyelogram & Ureteroscopy:* Invasive, with visible instruments. Symmetrical bilateral ureter imaging unlikely unless both sides instrumented; usually for tumors or strictures, not shown here.
D. *Antegrade Pyelography:* Contrast injected via percutaneous nephrostomy tube into kidney, flowing downward. Used when retrograde access blocked. No nephrostomy catheter visible here, ruling this out.
