What is NOT true about congenital PUJ (pelviureteric junction) obstruction?

Question

Image below highlights jugular foramen. Which of the following structures do not pass through the marked structure “A”?

Answer 1

This question tests which fact about congenital pelviureteric junction (PUJ) obstruction does not hold. Go through each option one by one.

Due to compression by an aberrant vessel rather than due to intrinsic causes: In children, an intrinsic defect in the ureter wall (an adynamic segment that fails to push urine forward) is the common cause. Vessel compression happens too, but less often, and it is seen more in adults than in babies. Calling vessel compression more common than intrinsic disease gets the pattern backwards, so this statement is false.
Retrograde pyelography is useful to find the site of obstruction: Dye injected up the ureter during this test outlines the narrow segment clearly, so this is true.
Whitaker's formula is useful for classification and treatment assessment: This test checks the pressure and flow across the PUJ under a set fluid load, and a raised pressure difference points to a true obstruction needing surgery, so this is true.
Antenatal diagnosis is possible: Routine fetal ultrasound regularly picks up hydronephrosis from PUJ obstruction before birth, so this is true.

The only false statement is the one about vessel compression being more common than intrinsic causes, since intrinsic disease is the usual cause in congenital PUJ obstruction.

Let's summarize:

Congenital PUJ obstruction is mostly from an intrinsic ureteric defect.
Retrograde pyelography, the Whitaker test, and antenatal ultrasound are all genuinely useful in this condition.

So the false statement is the one about an aberrant vessel being the main cause.

Answer 2

This question tests which fact about congenital pelviureteric junction (PUJ) obstruction does not hold. Go through each option one by one.

Due to compression by an aberrant vessel rather than due to intrinsic causes: In children, an intrinsic defect in the ureter wall (an adynamic segment that fails to push urine forward) is the common cause. Vessel compression happens too, but less often, and it is seen more in adults than in babies. Calling vessel compression more common than intrinsic disease gets the pattern backwards, so this statement is false.
Retrograde pyelography is useful to find the site of obstruction: Dye injected up the ureter during this test outlines the narrow segment clearly, so this is true.
Whitaker's formula is useful for classification and treatment assessment: This test checks the pressure and flow across the PUJ under a set fluid load, and a raised pressure difference points to a true obstruction needing surgery, so this is true.
Antenatal diagnosis is possible: Routine fetal ultrasound regularly picks up hydronephrosis from PUJ obstruction before birth, so this is true.

The only false statement is the one about vessel compression being more common than intrinsic causes, since intrinsic disease is the usual cause in congenital PUJ obstruction.

Let's summarize:

Congenital PUJ obstruction is mostly from an intrinsic ureteric defect.
Retrograde pyelography, the Whitaker test, and antenatal ultrasound are all genuinely useful in this condition.

So the false statement is the one about an aberrant vessel being the main cause.

What is NOT true about congenital PUJ (pelviureteric junction) obstruction?

Show Hint

The Correct Option is A

Solution and Explanation

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