Dietl crisis: Presentation and imaging findings in a 7-year-old boy

Rita Maria Lahoud, MD; William D. Esker, AAS, RT(R)(CT)(MR); Shirley A. Thurston, BS; Michelle Kohanski, RT(R)(CT); Jack S. Elder, MD; Ruth Lim, MD

Radiology Case Reports (Mar 2021)

Dietl crisis: Presentation and imaging findings in a 7-year-old boy

Rita Maria Lahoud, MD,
William D. Esker, AAS, RT(R)(CT)(MR),
Shirley A. Thurston, BS,
Michelle Kohanski, RT(R)(CT),
Jack S. Elder, MD,
Ruth Lim, MD

Affiliations

Rita Maria Lahoud, MD: Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Corresponding author.
William D. Esker, AAS, RT(R)(CT)(MR): Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
Shirley A. Thurston, BS: Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
Michelle Kohanski, RT(R)(CT): Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
Jack S. Elder, MD: Division of Pediatric Urology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
Ruth Lim, MD: Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA

Journal volume & issue: Vol. 16, no. 3
pp. 555 – 559

Abstract

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Intermittent ureteropelvic junction obstruction, or Dietl crisis, is a rare entity with sparse reports in published literature. Establishing the diagnosis is challenging given its intermittent nature. We report a case of Dietl crisis, focusing on ultrasound (US) and magnetic resonance urography (MRU) findings in a 7-year-old boy with recurrent episodes of colicky abdominal pain prompting multiple visits to the emergency department. Severe left hydronephrosis was visualized on US during one episode with complete resolution on follow-up US. MRU demonstrated severe left hydronephrosis with delayed calyceal transit time, time-to-peak enhancement, and excretion. There was no aberrant blood vessel. Surgical pyeloplasty provided complete symptomatic resolution. MRU can be a valuable tool in eliciting and dynamically confirming the diagnosis of Dietl crisis.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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