Gross hydronephrosis due to pelviureteric junction obstruction
Vague right sided abdominal pain "for years". Now worse.
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Grossly hydronephrotic right kidney with a thin mantle of enhancing cortex. No distended ureter thus congenital PUJ obstruction seems most likely. The kidney measures over 35 cm in length, filling the right side of the abdomen displacing the bowel to the left and liver upwards, and elevating the right hemidiaphragm. The left kidney is normal.