|Case 10 :|
|A 56-year-old male, known hypertensive and diabetic (known case of chronic renal failure, with previous ultrasound showing features suggestive of chronic medical renal disease, and bilateral small renal calculi) presents with anuria since 2 days. CT scan is performed. What is the diagnosis?|
|__________SCROLL FOR ANSWER__________|
shows bilaterally hydronephrotic kidneys with dilated pelvis, and peri-renal
fat stranding. Both ureters are dilated, and show upper ureteric calculi.
CT is now the examination of choice for the patient with typical renal
colic. Five mm thick cuts are obtained from top of the kidneys to the
bladder base. Definitive findings are hydronephrosis and hydroureter,
to the point of the obstructing stone readily visible on CT. Supportive
but non-diagnostic finding is perinephric stranding. Diagnostic accuracy
is well above 95%. In addition, in 10% of the patients another cause for
acute pain is discovered, unrelated to the urinary tract, such as appendicitis,
diverticulitis, ruptured aortic aneurysm, dissecting aortic aneurysm,
etc. The examination is quick and painless.
Dr. Rahul Sachdev, BR Diagnostics, New Delhi