Pyelography (pyelo-ureterography) a study of the normal and pathologic anatomy of the renal pelvis and ureter . equently causedby secondary inflammatory stenosis. The demonstration ofimmediate return flow is particularly of value in the differ-entiation of anatomic from pathologic obstruction. It mustbe remembered, however, that with obstruction to theureteral catheter as the result of anatomic conditions in thevesical portion of the ureter it may occasionally be im-possible to inject any fluid beyond the obstruction. In two stone shadows are visible in the right kidney lower
Pyelography (pyelo-ureterography) a study of the normal and pathologic anatomy of the renal pelvis and ureter . equently causedby secondary inflammatory stenosis. The demonstration ofimmediate return flow is particularly of value in the differ-entiation of anatomic from pathologic obstruction. It mustbe remembered, however, that with obstruction to theureteral catheter as the result of anatomic conditions in thevesical portion of the ureter it may occasionally be im-possible to inject any fluid beyond the obstruction. In two stone shadows are visible in the right kidney lower and larger of the two is situated at the first pointof narrowing in the upper ureter. Below it the dilated 248 PYELOGRAPHY ureter is visible, while no evidence of the injected solutionis apparent above the stone shadow. Extra-ureteral Shadow.—The relation of a shadow in thearea of the ureter to an opaque ureteral catheter has beengenerally accepted as the best method to determine whetherthe shadow is intra-ureteral. It was found, however, that ashadow may be extra-ureteral and still appear to be adjacent. Fig. 234.—Extra-ureteral shadows. to the outline of the opaque catheter. Further dilatation inthe ureter may permit a shadow to be at a distance of a centi-meter from the outline of the opaque catheter and still bewithin the ureter. The pyelo-ureterogram has been foundmore exact than the opaque catheter in the recognition ofextra-ureteral shadows. Even though the shadow in questionis in direct line with the ureter, if the outline of the latter isnormal throughout, the shadow may be regarded as being URETERAL STONE 249 situated outside of the ureter. In Fig. 234 two shadows arevisible along the course of the left lower ureter. If theirrelation to an opaque catheter were relied upon, one wouldinfer that the shadows were both intra-ureteral. The ab-sence of any dilatation in the ureter, however, would defin-itely determine that the shadows are extra-ureteral. In a sha
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectkidneys, bookyear1915
