‘Drooping water Lilly’ sign is seen in:
Correct Answer: Upper pole renal mass
Description: ANSWER: (D) Upper pole renal massREF: Sutton's textbook of radiology 7th edition, volume 2, page 933-934The classical drooping lily sign on IVU of duplication anomalies of ureters:* Duplication abnormalities (duplex kidneys) are characterized by two or rarely more ureters and renal pelvis. The lower pole moiety has been displaced inferolaterally by an upper pole hydronephrosis.* The duplication of the ureter may be incomplete (the ureters fusing at some point in their course and having a common distal ureter and orifice) or complete (both ureters having separate distal orifices* Incomplete duplication is almost always of no clinical significance, although in a small proportion of cases it may be associated with yo-yo reflux in which urine from one ureter refluxes back up the other ureter.* Completely duplicated meters are associated with a number of potential problems. If the upper moiety ureter is severely obstructed, the upper moiety becomes hydronephrotic and shows diffuse cortical loss, demonstrable on ultrasound, CT or MRI. The upper moiety may opacity late or not at all and the hydronephrotic pelvis may displace the lower pole moiety inferiorly, giving rise to the so-called drooping lily sign
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Radiology
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