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Severe localized hydronephrosis

Case contributed by Mohammadtaghi Niknejad

Presentation

Work up for hematuria.

Patient Data

Age: 80 years
Gender: Male

A 34 mm stone with a mean attenuation value of 1176 HU is present in the upper portion of the collecting system of the left kidney, causing the upper pole severe localized hydronephrosis and renal parenchymal atrophic changes. A few small stones are also evident within the hydronephrotic segment.

Large size sliding hiatal hernia is present.

Small fat containing an umbilical hernia is seen.

The prostate gland is enlarged and contains coarse calcified foci.

Degenerative changes as osteophytosis are seen in the lumbar spine.
Grade I spondylolisthesis of L3 on L4 and L4 on L5 is present. 

Case Discussion

Localized hydronephrosis is usually seen in the duplex collecting system, although an obstructing stone or mass in the major calyx or renal pelvis may cause localized hydronephrosis or hydrocalyx.

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