Presentation
Severe left loin pain and hematuria. PH of renal calculi.
Patient Data
Swelling of the left kidney is associated with thickening of the perinephric fat and dilatation of the left ureter down to the bladder where there is marked prostatomegaly and a small stone at the bladder base anterior to the prostate.
Case Discussion
The CT signs of ureteric obstruction are well known. On CT KUB it is inportant to determine the site and size of ureteric calculus. If a stone is not seen in the ureter it may have passed and should be looked for in the bladder. This is important for the clinician ie (1) the patient can be treated expectantly and (2) the stone is still present thus urine can be collected in an attempt to retrieve the calculus for biochemical analysis. Note the CT signs of ureteric obstruction can persist for some time after the stone has excited the ureter.
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