Steinstrasse and bladder calculus

Case contributed by Dr Hein Els

Presentation

Lower abdominal pain. Multiple previous treatments for renal and ureteric calculi.

Patient Data

Age: 51
Gender: Male
Modality: X-ray

Two radiodense calculi project over the pelvis of the right kidney. The densities to the right of L4 are most compatible with calculi in the right ureter creating a Steinstrasse sign. Large calcified calculus in the bladder engulfs a displaced JJ-stent. No calculi over the left renal tract. 

Modality: CT

Multiple calculi in the right distal abdominal ureter with proximal hydroureteronephrosis. There are also large calculi in the dilated right renal pelvis and in the lower pole of the right kidney. Large densely calcified bladder calculus engulfs the displaced JJ-stent (seen on bone windows, not included).

Incidental findings include prior left renal infarct and a small hypodense nodule at the uncinate process of the pancreas, likely a cystic pancreatic neoplasm which will require further characterization with MRI, among others. 

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Case Information

rID: 39209
Case created: 25th Aug 2015
Last edited: 28th Aug 2015
System: Urogenital
Inclusion in quiz mode: Included

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