What is the most common method of visualizing the collecting system for PCN?
Fluoroscopy is the most common method, but this requires opacification of the collecting system.
This can be accomplished by intravenous contrast material injection with antegrade excretion, if the patient has satisfactory renal function.
If the patient has impaired renal function or has a completely obstructed renal collecting system, fluoroscopy may not be a viable option.
In these situations, an antegrade pyelogram can be performed via a 22 G or 25 G needle. An antegrade pyelogram can be performed with iodinated contrast material or CO 2 gas