A case study of pyelolymphatic backflow demonstrated on CT

Abstract

Pyelolymphatic backflow is a rare type of pyelolymphatic fistula that occurs in cases of urinary obstruction. This phenomenon may help to decompress an acutely obstructed kidney, and therefore, alleviate renal function from deteriorating. Pyelolymphatic backflow has specific imaging characteristics best shown on CT urography. Our case study aims to improve the understanding and diagnosis of pyelolymphatic backflow by presenting a case of pyelolymphatic backflow seen on CT urography, including discussions on the pathophysiology, clinical relevance and management of this phenomenon. Our case study demonstrates the opacification of landmark lymphatic structures including the retroperitoneal para-aortic lymphatic chain, cisterna chyli and thoracic duct, which have not been demonstrated previously.

Keywords

• Pyelolymphatic backflow
• Pyelolymphatic fistula
• Computed tomography