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Latest revision as of 02:03, 8 November 2019

Hydronephrosis
Hydronephrosis

History

30 year old female with bilateral hydronephrosis discovered on ultrasound

Findings

The 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 Diagnosis

Non-Hodgkins lymphoma with resultant ureteral obstruction or Gastric carcinoma with nodal metastasis and resultant ureteral obstruction

Case Diagnosis

Obstructive hydronephrosis

Treatment & Follow Up

The patient underwent a biopsy of the stomach lesion which revealed poorly differentiated gastric adenocarcinoma.