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Puzzling pyramids
  1. Katrina Harborne,
  2. Helen Williams
  1. Department of Radiology, Birmingham Children’s Hospital, Birmingham, UK
  1. Correspondence to Dr Helen Williams, Department of Radiology, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham B4 6NH, UK; helen.williams32{at}

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A 1-day-old term baby boy presented with bilious vomiting and was found to have mild renal impairment. No abnormality was detected on antenatal ultrasound scans. He had a normal upper gastrointestinal contrast study, which ruled out malrotation as the cause of his bilious vomiting. The surgical team requested an ultrasound of his renal tract to look for any structural abnormality that may be causing renal impairment. Both kidneys were normal in size and had similar appearances. Look at the longitudinal (figure 1) and transverse (figure 2) ultrasound images of …

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.