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Right side flank pain, nausea, and vomiting for three days.
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The case illustrates a chain of multiple calculi in the distal right side ureter and pronounced hydroureteronephrosis upstream which is relatively uncommon. The calculi are the most common cause of ureteral obstruction and in chronic and recurrent cases can lead to chronic renal disease and also be complicated by infection. The best imaging modality for the detection of urinary tract calculi is non-contrast MDCT.