Distal ureteric calculus causing partial obstruction

Case contributed by Subash Thapa


Severe right loin pain for 2 days

Patient Data

Age: 30 years
Gender: Male

Color Doppler study shows twinkling artifacts in the right distal ureter suggestive of calculus and demonstration of intravesical ureteric jet suggestive of partial obstruction.  

There is mild to moderate right hydroureteronephrosis.

Case Discussion

Color Doppler interrogation improves the detection of small, minimally shadowing calculi by demonstrating twinkling artifacts 1.

Trans-abdominal evaluation of ureteral orifices for intravesical ureteric jets is helpful to assess for obstruction.

Color Doppler evaluation of the ureteral jets can improve the detection of obstruction. Patient with high grade obstruction will have either a completely absent jet or a continuous, low jet on the symptomatic side 2.

Color Doppler can also be used to assess the possibility of spontaneous ureteral stone passage. Intravesical ureteric jet on the renal colic side associated with resistive index (RI) values of 0.7 or less and delta RI values of 0.06 or less is suggestive of spontaneous passage of stone in 71% of cases 3.

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