Pyelonephritis in a solitary kidney
Abdominal pain and fever.
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Solitary enlarged left kidney. There is a focal wedge-shaped area of cortical hypoattenuation in the left interpolar region. Surrounding fat stranding and enlarged left para-aortic lymph nodes. There is a tiny right renal bud seen but a right ureter is present. Hepatic flexure fills the renal bed. No other genitourinary tract anomaly identified.
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Renal agenesis is not uncommon, with an incidence estimated at 1 in 1000. There are many associations of renal agenesis and these should be sought out on imaging studies.