Presentation
Left-sided abdominal pain.
Patient Data
Age: 45 years
Gender: Female
From the case:
Hydronephrosis due to calculus
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Longitudinal

Gross hydronephrosis with marked thinning of cortex means longstanding pathology. Marked dilatation of the ureter. Echogenic filling defect with shadowing in the distal ureter with collapse beyond indicates probable calculus. So called "twinkle" artifact in the luminal filling defect on color Doppler confirms a dense calculus.