Presentation
Left abdominal pain.
Patient Data
Non-contrast abdomen and pelvis CT showing multiple cysts, some of them confluent, involving the liver parenchyma, as well as bilateral kidney enlargement due to polycystic disease. There are some small calcifications within the cystic walls suggesting residual foci and some calcifications that seem to be into the calyceal system suggesting renal calculi. The left ureter is mildly enlarged due to a small (3.5 mm) calculus in its distal third. The remainder of the exam is unremarkable within this protocol.
Case Discussion
This patient has a known history of autosomal dominant polycystic kidney disease (ADPKD) and previous records of nephrolithiasis crisis treated in the emergency department. Nephrolithiasis occurs in approximately a fifth of patients with ADPKD 1-2.