11.29.21
Publication Date: 2021-11-29
3 images
Findings
Opposite lateral and VD radiographs of the abdomen are available for interpretation. There is mildly decreased detail and fluid streaking in the peritoneal cavity and mild fluid streaking in the retroperitoneal space.
The left kidney is moderately to severely enlarged with smooth, rounded margins. There are at least 3 large, ovoid, mineral opaque structures in the plane of the caudal retroperitoneal space (at the level of L6 and L7), the largest of which measures approximately 0.4 x 0.7 cm. On the VD projection, these structures are superimposed with the caudal lumbar spine, slightly to the left of mid-line. There is a large amount of rounded to linear mineralization in the plane of the right renal pelvis and diverticula. The right kidney is on the lower limits of normal in size. The urinary bladder is minimally distended and its margins are largely obscured. On the lateral projections, there are numerous faint pinpoint to small mineral opaque foci in the plane of the caudal abdomen, immediately cranial to the ilia, suspected to be in the plane of the urinary bladder.
The liver, spleen and gastrointestinal tract are normal.
An incidental metal opaque wire bristle foreign body is present in the right cranioventral abdomen. A surgical implant for a previous tibial tuberosity transposition surgery is in place in the (suspect) left proximal tibia.
Diagnosis
- Multiple, large, distal left ureteroliths with secondary left obstructive hydronephrosis. Right renal degenerative changes and mineralization. Numerous small cystoliths. - Mild peritoneal and retroperitoneal effusion may represent an inflammatory or transudative process; a uroabdomen cannot be entirely excluded. Other etiologies are considered unlikely.
Discussion
The patient underwent surgical ureteroneocystostomy and is currently doing well.
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