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Urinary reflux from renal pelvis and calices into the collecting ducts.
In this video the phenomenon is demonstrated during Ureteroscopy while the collective system is opacified via retrograde insertion of contrast medium.
Depending on the degree of reflux it can occur as:
Pyelotubular reflux
Pyelovenus reflux
or even Fornix rupture

Pyelovenous backflow is an important phenomenon since it may be one of the natural mechanisms of pelvic decompression in ureteral obstruction. It also may be an avenue for the bacteremia following ureteral reflux

Pyelovenous backflow can occur from:
Rupture of tubules in the straight and arcuate vein.
or minute calyceal mucosal tears and ruptures of the fornix with extravasation of the contrast medium into the arcuate vein.
During a ureterolithotripsy of a stone in the upper ureter profound bleeding occurred after placement of r=the ureteric sheath in order to proceed with flexy URS
A large blood clot in renal pelvis presenting as a filling defect
The clot is a great deal washed out allowing a better view.

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