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Search Results for => hydronephrosis <= Result Items 1 - 20
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Case ID: 11815

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DiagnosisRight hydronephrosis
History59 year-old HIV positive male, on HAART, presenting with 4 day history of right flank and abdominal pain. History of nephrolithiasis since beginning protease inhibitor therapy.
FindingsMultiple axial CT views of the abdomen without contrast demonstrating an enlarged right kidney with loss of intrapelvic fat, right-sided dilation of collecting system with proximal right ureteral dilatation. No evidence of radiopaque stone in bilateral ureters. Small stone in right collecting system.
Differential Dx-left-sided hydronephrosis -radiolucent stone secondary to protease inhibitor therapy -radiopaque stone undetected on CT -obstruction secondary to neoplasm
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ContributorAndrew W Harbuck :: National Naval Medical Center Bethesda - Author Info
ReviewerAngela Levy, M.D. :: Georgetown University Hospital - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 9446

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DiagnosisNephrolithiasis (ureteral Stone), hydronephrosis & perinephric fluid, Hydroureter & periureteral fluid
History42 yo woman with right flank pain.
Findingshydronephrosis (right) with extravasation of perinephric fluid, tracking within Gerota's fascia Right hydroureter with periureteral fluid Right distal ureteral stone
Differential DxDdx: ureterolith, phlebolith, Causes of unilateral reniform enlargement: 1. Ureteral obstruction 2. Duplication anomalies and hypertrophy 3. Parenchymal infiltration A. Cellular infiltrates (pyelonephritis, XGP, Contusion, Infiltrating neoplasm) B. Edema (Acute renal vein occlusion, Acute arterial occlusion/arteritis). Zagoria, R. Genitourinary Radiology: The Requisites, 2nd ed, 2004.
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ContributorHoward Crisp :: Eastern Virginia Medical School - Author Info
ReviewerMaria Flynn :: National Capital Consortium - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 9379

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Diagnosishydronephrosis
HistoryPatient presented to his Primary Care Manager with new onset of gross hematuria.
FindingsMarked hydronephrosis of the right renal pelvis and calices and mild to moderate hydronephrosis on the left. There is a soft tissue connection between the lower poles of the kidneys.
Differential DxHorseshoe kidney with bilateral hydronephrosis.
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ContributorKenneth Terhaar :: Naval Medical Center Portsmouth - Author Info
ReviewerMaria Flynn :: National Capital Consortium - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 8649

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DiagnosisGiant hydronephrosis, with hydroureter secondary to large ureterolith.
History19 yo Hispanic male presenting with a one-year history of increasing abdominal girth concerning for a mass. No known medical problems or contributory family history.
FindingsSevere left-sided hydronephrosis and hydroureter, causing prominent mass effect on the underlying bowel and vasculature. The cause is likely the 18mm ureterolith in the distal left ureter, just proximal to the ureterovesical junction.
Differential DxMany causes of obstruction can be considered, such as stricture, stone, or mass, until the ureterolith just proximal to the UVJ is visualized.
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ContributorJoel McFarland :: National Naval Medical Center Bethesda - Author Info
ReviewerMarcia C. Javitt :: Walter Reed National Military Medical Center - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 8247

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Diagnosishydronephrosis
History46 year old with severe back pain after climbing a ladder.
FindingsPlain radiographs of the lumbar spine demonstrate a well circuscribed calcification in the right upper quadrant at the level of L3. Sonographic images of the kidneys demonstrate hydronephrosis with a 1.1 cm calcification in the right ureteropelvic junction(UPJ). CT of the abdomen confirms the location of a 9 mm stone in the right UPJ.
Differential DxPlain radiographic differential for a calcification in the right upper quadrant: Cholelithiasis Nephrolithiasis Calcified lymph node Granuloma in liver Artifact within bowel
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ContributorRick Riego de Dios :: National Capital Consortium - Author Info
ReviewerAlbert V Porambo :: Civilian Medical Center - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 7364

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DiagnosisXanthogranulomatous pyelonephritis: renal calculi, secondary hydronephrosis and chronic infection.
History43 yo female with recurrent UTI presents with right flank pain, low grade fevers, and vomitting.
FindingsThe right kidney is enlarged and hydronephrotic with an obstructing stone at the renal pelvis.
Differential DxHigh grade obstructive hydronephrosis
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ContributorAaron Cho :: Naval Medical Center Portsmouth - Author Info
ReviewerStephanie A Bernard :: Penn State University - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 6795

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DiagnosisPrenatal hydronephrosis of unknown etiology as of yet.
History22 year old woman comes for routine OB ultrasound and the fetus is found to have mild hydronephrosis. The woman had close interval followup exams. On most recent follow up exam, fetus found to have markedly progressed renal pelvis dilatation.
FindingsImages from 16 SEP 2003 demonstrate renal pelvis dilatation to approximately 7mm in AP dimension bilaterally. Normal appearing renal parenchyma and bladder. Normal amniotic fluid volume. Follow up sonogram on 17 OCT 2003 demonstrate interval decrease in the renal pelvis dimension to a less significant measurement of 4mm bilaterally. Follow up exam on 23 DEC 2003 demonstrate marked worsening of renal pelvis size. Current measurements up to 14mm bilaterally. Additionally there is calyceal dilatation bilaterally. The renal parenchyma remained normal however. No cortical atrophy identified. The bladder is also dilated and did not empty during the exam, which took over 1.5 hours to complete and fully evaluate with staff review. The bladder wall was not particularly thickened on this exam. The distal ureters are dilated bilaterally. There was a relative oligohydramnios seen during the exam. Although gestastional age at the time was approximately 36 weeks.
Differential Dx1. Vesico-ureteric reflux 2. Posterior urethral valves 3. UVJ obstruction 4. Prune-belly syndrome 5. UPJ obstruction
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ContributorMatthew J Hoffman :: National Capital Consortium - Author Info
ReviewerWilliam R Carter, M.D. :: National Naval Medical Center Bethesda - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 6679

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DiagnosisTransitional Cell Carcinoma of the Bladder resulting in Bilateral hydronephrosis
History65 year old hispanic man presents with bilateral flank pain and acute renal insufficiency. Screening ultrasound performed demonstrates bilateral hydronephrosis. Distal obstruction is suspected, leading to CT of the pelvis demonstrating tumor along the trigone region of the bladder, obstructing both ureteral orifices.
FindingsSonography demonstrated bilateral hydronephrosis resulting in suspicion of distal obstruction. CT of the pelvis demonstrates asymmetric thickening of the posterior (trigone) wall of the bladder resulting in obstruction of both ureteral orifices.
Differential DxNeoplastic causes: transitional cell cancer squamous cell cancer adenocarcinoma leiomyoma paraganglioma fibroepithial polyps nephrogenic adenomas neurofibromas haratomas Non-neoplastic causes of infection or extrinsic processes: perivesical inflammation from diverticulitis or appendicitis; Crohn's disease; pelvic inflammatory disease; cystitis cystica with recurrent UTI; cytitis glandularis; malakoplakia.
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ContributorThomas P. Eberle :: National Capital Consortium - Author Info
ReviewerWilliam R Carter, M.D. :: National Naval Medical Center Bethesda - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 6481

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DiagnosisCervical cancer with bilateral hydronephrosis
History29 y/o G6P5051 female arrived on airevac from micronesia island with history of post-coital bleeding.
Findings-6 x 6 cm cervical mass with infiltrated surrounding fat, consistent with cervical cancer. -There are several prominent asymmetric pelvic lymph nodes on the left side. These are not pathologic by size criteria, however, in the presence of nearby malignancy these may represent metastatic disease. -There is mild bilateral hydronephrosis from the cervical mass compressing both ureters. Additionally, the image through the kidneys demonstrates delayed nephrogram of the right kidney secondary to higher back pressure of the right hydronephrosis compared with the left.
Differential Dxcervical cancer
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ContributorMichael Krasnokutsky :: Uniformed Services University - Author Info
ReviewerGreg Petermann :: Tripler Army Medical Center - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 6049

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DiagnosisObstructive hydronephrosis
History30 year old female with bilateral hydronephrosis discovered on ultrasound
FindingsThe MAG3 renal scan demonstrated prompt but decreased blood flow to both kidneys. Cortical uptake in both kidneys was also decreased, less in the left kidney. The size of the left kidney was also smaller than that of the right kidney. Delayed excretion was present in both kidneys without clearance. In this patient, cortical transit in both kidneys was markedly delayed; therefore, diuretic challenge was not performed. A CT scan of the abdomen and pelvis demonstrated thickening of the stomach wall and a conglomerate mass of para-aortic lymphadenopathy. Bilateral hydronephrosis was present.
Differential DxNon-Hodgkins lymphoma with resultant ureteral obstruction or Gastric carcinoma with nodal metastasis and resultant ureteral obstruction
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ContributorAlice Boyd Smith :: Uniformed Services University - Author Info
ReviewerSun Y Kim :: Walter Reed Army Medical Center - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 4669

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DiagnosisBilateral hydronephrosis
HistoryThe patient is a 54yo WF with HTN, scoliosis, and a 15 year history of breast cancer with known bony metastases (with a history of sacral X-ray therapy for metastases). She presents with a 16 month history of worsening urinary frequency, hourly nocturia, and occasional overflow incontinence. She has no hematuria, pyuria, or dysuria. She had no costo-vertebral angle or back tenderness. Laboratory data were significant for a stable creatinine level of 0.8 to 0.9 and urinalysis was unremarkable and without sediment.
Findings=>The scout film reveals multiple scattered surgical clips throughout the abdomen and pelvis. She demonstrates dextro-convex scoliosis and severe degenerative disk disease at L4-L5 as well as sclerotic lesions in the L4-L5 region. =>The IVP sequence shows the same findings as above along with bilateral hydronephrosis and caliceal blunting. The kidneys are normal in size (~3.5x vertebral body height) and contour, without evidence of a mass. The cortex appears grossly normal in thickness bilaterally. The ureters are incompletely visualized bilaterally, but the visualized portions are normal. The superior margin of the filled bladder demonstrates an irregular contour. =>The post-void residual image displays an abnormally high residual amount.
Differential DxThe bilaterality of this case would seem to suggest that the obstruction is to the urethra. This is supported by the high post-void residual and the patient's symptomatology. However, given her known history of metastatic malignancy, abdominal surgery, and sacral X-ray therapy, it is quite possible that she may have multiple sites of partial obstruction from mass or fibrosis. It is also quite possible that she may have some neurologic compromise secondary to any of these processes that is contributing to her symptoms.
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ContributorMS-4 USU Teaching File :: Uniformed Services University - Author Info
ReviewerJames George Smirniotopoulos, M.D. :: Uniformed Services University - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 4201

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Diagnosishydronephrosis
History32 year old G1P0 at 21+2 weeks gestational age obtaining ultrasound examination to determine estimated delivery date.
Findingsdilated fetal renal pelves
Differential Dxobstructive hydronephrosis nonobstructive hydronephrosis physiologic dilatation
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ContributorAaron M Taylor :: National Capital Consortium - Author Info
Reviewer :: - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
Case ID: 3918

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Diagnosishydronephrosis of the right ureter secondary to extrinsic mass compression from a leiomyoma of the uterus (demonstrated by CT).
HistoryA 32 year old female with several month history of abdominal pain.
Findings- Abdominal radiograph demonstrates a soft tissue density over the pelvis. - A post void image of an intravenous urogram study demonstrates hydronephrosis of the right collecting system with normal, symmetric kidney sizes. There is delayed opacification of right collecting system. Delayed images demonstrate ureteral narrowing at a level above UVJ at the level of the mid right ureter.
Differential Dx
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ContributorWilliam A Mercanti :: National Capital Consortium - Author Info
ReviewerMaria Elena Pace, M.D. :: Uniformed Services University - Editor Info
Case Accepted: 2008-04-02 12:40:48-04 :: Revised: :: Submitted:
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