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Case 1

HISTORY

An elderly man with a past history of renal calculi and left ureteric stent presented with abdominal pain.

ULTRASOUND FINDINGS

There is hydronephrosis of the right kidney. The left kidney has a midpole calculus and the stent can be seen passing into the upper calyx. The distal end of the stent can be seen curling in the bladder (seen on the movie loop). There is a stone in the right distal ureter at the vesico-ureteric junction. There is low level streaming of urine seen from the right ureteric orifice.

DISCUSSION

Ureteric stones are difficult to detect unless at the pelvi-ureteric or vesico-ureteric junction. The dilated ureter and hydronephrosis suggests obstruction from this stone. Ureteric jets can be helpful to determine obstruction if asymmetric or displaying 'streaming' (low velocity, continuous flow rather than intermittent, vigorous jets). There is considerable variation in normal jet to jet intervals and therefore a long duration of observation is required before concluding that there is reduced jets on one side.

SUBMITTED BY

Adrian Goudie


Right kidney long

Right kidney long

There is dilation of the pelvi-calyceal system.
Right kidney long Right kidney trans Left kidney long Left kidney long Bladder, distal rt ureter Bladder trans