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Gigantic hydronephrosis

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Known renal impairment. Prior stones. Rigors.

Patient Data

Age: 60 years
Gender: Male
ct

The right kidney is severely hydronephrotic occupying the whole of the right side of the abdomen. The cortex is diffusely thinned to 1 mm.

14 mm stone at the right VUJ.

Normal left kidney.

Trace pelvic free fluid.

Right basal round atelectasis.

Case Discussion

The kidney is grossly enlarged. A nephrostomy was placed under ultrasound guidance, through an anterolateral approach. 4 liters of infected fluid was drained in the first 12 hours.

Subsequent analysis of the urine diagnosed genitourinary tuberculosis.

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