A 25 yo man presents at the ER with abrupt, intense pain in the right flank and ipsilateral lower abdomen. In addition to abdominal pains, he also feels pain in the right testicle and has had to urinate frequently and always with pain. Imaging was done to aid in assessment.
Given this information, what diagnosis might you suggest? Explain the symptoms and what is revealed by the imaging. What treatment do you suggest?
April 28, 2015 at 6:32 pm
Diagnosis: Renal Calculi
Right Flank and lower abdominal pain is stone moving thru ureters. Pain in groin suggest renal calculi. Pain on elimination suggest calculi. Image suggest calculi in ureters. I have a hard time interpreting that image.
April 28, 2015 at 6:34 pm
Treatment suggestion, fluids, pain medications, filtering urine to catch stones for identifier of type. Possible antibiotic if signs of infection. (possibl because of the pain when urinating)
April 29, 2015 at 3:01 pm
OK, good. I was thinking the same thing. But take a look at the radiogram. Let’s assume that the arrow indicates the Ureter / Bladder Junction and the structure superior and lateral to that is the right kidney. What can you make of what is happening to the kidney?
April 29, 2015 at 6:25 pm
Is the calculi blocking there urine from passing thru the ureter into the bladder? Could it be hydronephrosis?