A CASE OF URETERAL REFLUX IDENTIFIED BY ULTRASOUND

Reflux nephropathy is known to be a major cause of renal failure in ch ildren. Vesico-ureteral reflux is usually diagnosed by voiding cysto-u rethrography (VCG). However, it has been observed that conventional VC G is not always reliable for the diagnosis of ureteral reflux. In the case of a 5 year old girl with recurrent febrile urinary tract infecti on, VCG showed no ureteral reflux. Urodynamic study revealed a targe b ladder capacity and significant residual urine. Renal scintigram delin eated a right renal scar. Simple ultrasound examination with videotape recording during voiding definitely demonstrated the presence of sign ificant ureteral reflux when she voided, that is, there was marked dil atation of the right distal ureter and ballooning of the right renal p elvis on voiding, and quick refilling of the bladder concomitantly wit h the disappearance of the pelvic ballooning. Therefore, an ultrasound during voiding may be useful for diagnosing ureteral reflux in patien ts where a VCG does not reveal reflux.