Portal venous phase IV contrast-enhanced CT abdomen/pelvis. Reversed corticomedullary differentiation in the kidneys bilaterally in keeping with acute cortical necrosis. 6 mm obstructing calculus at the pelvic ureteric junction, with associated moderate right hydronephrosis. No left hydronephrosis. 2.5 cm left inferior pole renal cyst.
Moderate volume free fluid throughout the abdomen, most prominent in the pelvis and perihepatic regions. Periportal oedema and mild hepatomegaly. Mild oedema in the large bowel wall, which may be related to overall fluid overloaded state.
Conclusion: Acute renal cortical necrosis, which may be secondary to septicaemia from right renal calculus causing obstructive pyelonephritis. Gross fluid overload noted.