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Vesicoureteral junction calculus

Case contributed by Zuhoor Ud Din
Diagnosis certain

Presentation

Right-sided flank pain radiating to groin area and glans penis with urinary urgency and dysuria

Patient Data

Age: 25 years
Gender: Male

Transabdominal US

ultrasound

Transabdominal ultrasound study shows a 6 mm calculus at right vesicoureteral junction protruding into the urinary bladder lumen with overlying edematous vesicoureteric junction. Ureteral jet and twinkle artifact are also seen.

Case Discussion

25 years old male patient, presented to our emergency department with complaints of right sided flank pain - radiating to the groin area and glans penis. He was also complaining of dysuria and urinary urgency. 

While scanning the right kidney and ureter, it was noticed that he had right sided hydroureteronephrosis. Careful scanning of the kidney revealed no calculi and tracing the right ureter into the bladder at vesicoureteral junction showed a calculus impacted there. 

Sonological findings of the stone are:

  • echogenic structure  
  • with posterior shadowing  
  • twinkle artifact with color Doppler interrogation

The area was thoroughly scanned in different transverse and longitudinal planes. The presence of calculus was also most likely, as it was producing the famous "twinkle artefact" seen on color Doppler.

There were also occasional ureteral jets, indicating partial occlusion caused by the calculus. 

Rest of the abdominopelvic examination was normal. 

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