Atrophic kidney due to severe chronic obstructive hydronephrosis

Case contributed by Bruno Di Muzio
Diagnosis almost certain


Right flank migrating pain. Previous history of kidney stones.

Patient Data

Age: 50 years
Gender: Male

CT Abdomen and pelvis (KUB)


CT in KUB protocol showing a small calculus in the distal third of the right ureter promoting mild hydroureteronephrosis on this side. A left atrophic kidney is observed with a 1,6 cm calculus impacted in the pyeloureteral junction and causing chronic obstructive hydronephrosis. The left kidney measures 8,6 cm and the right kidney measures 12,9 cm. 

The remainder of the exam is unremarkable. 

Case Discussion

This case illustrates a silent atrophy of the left kidney due to chronic obstructive hydronephrosis.

On the contralateral side, there is a mild hydroureteronephrosis due to a distal small calculus that is the cause of the current symptoms.

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