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Obstructing ureteric calculus

Case contributed by Vikas Shah
Diagnosis almost certain

Presentation

Left sided abdominal pain and tenderness. Raised temperature and inflammatory markers. ?diverticulitis

Patient Data

Age: 55 years
Gender: Male

Non obstructing 18 mm calculus in right renal pelvis.

Obstructing 7 mm calculus at left vesico-ureteric junction with upstream left ureteric and pelvicalyceal system dilatation. Fat stranding around left ureter. Abnormal enhancement of lining of left ureter and left pelvicalyceal system suggests infection. Reduced enhancement of left kidney compared to right.

No other abnormalities.

Case Discussion

Obstructive uropathy secondary to stone at VUJ. The abnormal urothelial enhancement raises the possibility of super-added infection.

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