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Drooping lily sign

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The drooping lily sign is a radiological finding observed on imaging studies of the kidneys, most commonly associated with duplex collecting system and obstruction of the upper moiety. This sign is characterized by the appearance of a compressed, non-obstructed lower renal moiety, which takes on a "drooping" or displaced appearance due to the distension of the obstructed upper moiety.

Pathophysiology

The drooping lily sign is typically seen in the context of a duplex collecting system, a congenital anomaly in which the kidney has two separate ureters draining from two distinct renal segments (upper and lower poles). When the ureter draining the upper moiety becomes obstructed, often by a ureterocele (a cystic dilation of the distal ureter within the bladder), the upper moiety becomes dilated while the lower moiety remains functional and compressed.

The "drooping" appearance arises due to the enlarged upper moiety compressing and displacing the lower moiety downward and laterally. The non-obstructed lower moiety maintains normal function but appears smaller and distorted on imaging.

References

  1. ^ McPherson, Amie M.; Dyer, Raymond B. (1 August 2015). "The drooping lily sign". Abdominal Imaging. 40 (6): 2056–2057. doi:10.1007/s00261-015-0375-2. ISSN 1432-0509. Retrieved 22 December 2024.
  2. Callahan, Michael J. (April 2001). "The Drooping Lily Sign". Radiology. 219 (1): 226–228. doi:10.1148/radiology.219.1.r01ap01226. ISSN 0033-8419. Retrieved 22 December 2024.
  3. Sahakyan, Karine; Spevak, Melissa R.; Ziessman, Harvey A.; Gorin, Michael A.; Rowe, Steven P. (May 2018). "The Scintigraphic Drooping Lily Sign". Clinical Nuclear Medicine. 43 (5): 352. doi:10.1097/RLU.0000000000002049. ISSN 0363-9762. Retrieved 22 December 2024.