Large ureteric calculus causing severe hydronephrosis

Case contributed by Thuấn Nguyễn Hoàng
Diagnosis certain

Presentation

Left renal colic.

Patient Data

Age: 50 years
Gender: Male

The KUB shows a large left kidney outline and a large hyperdense oval opacity in the left hypogastric region.

This opacity is unusual for a ureteric calculus although its location and density are possibly a ureteric calculus at the vesicoureteric junction. Other differentials to consider include a stone in the bowel or bladder, or lymph node calcification.  

CT-KUB shows a large stone in the left ureter that causes severe hydronephrosis of the left kidney and a severely dilated ureter. It is presumably long-standing given the degree of dilatation and renal cortical atrophy. 

Case Discussion

A large hyperdense oval mass in lower pelvic has a broad differential diagnosis. It may be a stone in the ureter or GI tract or calcification of a lymph node.

CT is a good choice to differentiate these possible causes.

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