Presentation
Bilateral renal colic with fever.
Patient Data
Age: 50 years
Gender: Female
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- right kidney shows:
- hydronephrosis with ureteral dilatation up to L5 level where there is an ureteral stone (measuring 15 mm, mean density = 1050 HU), obstructing the ureteric lumen
- delayed excretion with alternating linear bands of low and high attenuation in a radial pattern extending through the corticomedullary layers well-visualized on excretory phase in keeping with a striated nephrogram
- cirumferential ureteral wall thickening with enhancement in keeping with ureteritis
- forniceal rupture with small subcapsular urinoma at the lower pole with perinephric fat stranding
- the left kidney is moderately enlarged and shows:
- hydronephrosis with dilated ureter up to S1 level where there is an ureteral stone (17 mm, mean density = 850 HU)
- striated nephrogram well-visualized on excretory phase
- circumferential ureteral wall thickening with enhancement in keeping with ureteritis
- Normal appearance of the urinary bladder
Multiple uterine leiomyomas (known).
Case Discussion
CT Urogram features of bilateral obstructive uropathy due to ureteral stones with pyelonephritis, ureteritis and renal forniceal rupture with subcapsular urinoma.
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