Pyelography (pyelo-ureterography) a study of the normal and pathologic anatomy of the renal pelvis and ureter . they were situated as low as the brimof the bony pelvis, if neither of them showed in their out-line any evidence of mechanical dilatation, we would haveno objective data to warrant operation. Further, if theureter showed angulation at any portion of its course, eventhough it were well marked and acute, unless dilatation ofthe ureter and pelvis existed above it, no objective data towarrant surgical interference would be present. It may beconceivable, however, that subjective data may
Pyelography (pyelo-ureterography) a study of the normal and pathologic anatomy of the renal pelvis and ureter . they were situated as low as the brimof the bony pelvis, if neither of them showed in their out-line any evidence of mechanical dilatation, we would haveno objective data to warrant operation. Further, if theureter showed angulation at any portion of its course, eventhough it were well marked and acute, unless dilatation ofthe ureter and pelvis existed above it, no objective data towarrant surgical interference would be present. It may beconceivable, however, that subjective data may be so dis-tinct as to warrant an operation in selected cases. Thiswould rarely be the case when both renal pelves are foundto be extremely low. ABNORMAL POSITION 81 The pelvis of the movable kidney is frequently seen tobe unusually large, and the calyces in particulai* may appearto be distended and broader than normal. Occasionallythe increase in size is so great as to approach the border-line stage, where the differential diagnosis from actual hy-dronephrosis may be difficult. In all probability the kid-. Fig. 47.—Movable kidney; abnormal position of kidney. ney assumes certain positions, so that the interference withthe urinary drainage, although not prolonged or marked, issufficient slightly to dilate the pelvis. In Fig. 47 the pelvisof the right kidney is situated opposite the fourth lumbarvertebra, just above the crest of the ilium. It is normal insize and contour. Although there is marked angulation in6 82 PYELOGRAPHY the ureter just below the ureteropelvic juncture, there is noevidence that it is the cause of any symptoms. The local-ized irregular areas of evident dilatation are caused byprofuse return flow. In Fig. 19 the right pelvis is unusu-ally low, being situated on a level with the crest of theilium. The caudad direction of the calyces shows thatthe kidney was partially rotated. Although incompletelyfilled, the calyces are unusually large and probably slightly
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectkidneys, bookyear1915
