What's the Diagnosis? By Dr. Michael Tom
Wed, 09/13/2017 - 8:00am
A 40 yo female presents with right flank pain. The pain is sharp, intermittent and associated with dysuria. She has no fever, hematuria or n/v. Vitals are normal, she appears uncomfortable on exam and she has right flank tenderness. UA reveals +Nitrate, <180WBC, 40RBC What's the diagnosis? (scroll down for answer)
Diagnosis: Mild-moderate right hydronephrosis
- Urinary tract obstruction, in this case secondary to a distal ureteral stone, can lead to infection, sepsis, and permanent renal injury
- Patients with infection in conjunction with obstructing renal stone require urologic consultation and admission for IV antibiotics covering gram negative organisms
- Urologic interventions for nephrolithiasis include shock wave lithotripsy, ureteral stenting and less commonly laparoscopic stone removal