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Lower ureteric stricture with large calculus

Case contributed by Aditya Shetty
Diagnosis almost certain

Presentation

Left-sided flank pain. Ultrasound exam showed 2 cm calculus in left lower ureter.

Patient Data

Age: 30 years
Gender: Female

IVP shows a left lower ureteric calculus on control film most likely near the vesicoureteric junction.

The contrast study shows a moderately dilated ureter and the calculus is seen to move up and down.

The left ureter has an abrupt narrowing with dilatation of the proximal part.

Case Discussion

There is a stricturous narrowing of the left lower ureter adjacent to the left vesicoureteric junction (VUJ) causing stasis of urine and thereby predisposing to calculus formation.

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