Prune Belly Syndrome

  • Etiology: triad is hypoplastic abdominal wall musculature / urinary tract dilation (but not obstructed) / cryptorchidism
  • VCUG: dilated posterior urethra, trabeculated thick walled bladder, bilateral hydroureteronephrosis from vesicoureteral reflux -> renal damage so kidneys can be small + echogenic on US
  • Clinical: pulmonary hypoplasia due to oligohydramnios, patent urachus helps to decompress, hydroureteronephrosis + bladder distension leads to flank masses

Radiology Cases of Prune Belly Syndrome

AXR of peripherally inserted central catheter / PICC in the renal vein in a patient with gastroschisis
AXR AP and lateral shows a right lower extremity PICC coursing across the midline with its tip projecting over the left renal vein. The abdomen appears to be bulging and protruberant in both medial-lateral and anterior-posterior dimensions. The tip of the bladder catheter projects high within the pelvis within a dilated bladder

Clinical Cases of Prune Belly Syndrome

Clinical image of prune belly syndrome / Eagle Barrett syndrome
Clinical image shows a small thorax, a bulging abdomen due to hypoplastic abdominal wall musculature, and bilateral undescended testicles.
Clinical image of prune belly syndrome
Clinical image shows hypoplastic abdominal wall musculature. The bladder drainage catheter (center of image) was used to decompress the patient’s dilated genitourinary system in-utero. The patient also had a small thorax and bilateral undescended testicles.