Presentation
Three days lower abdominal pain with fevers, nausea. WCC +++ in urine.
Patient Data
Mild prominence of the collecting system on the left. Both kidneys enhance normally with no surrounding stranding. Both ureters show peripheral wall enhancement, most pronounced in the proximal left ureter.
The bladder is thick-walled and also demonstrates peripheral enhancement. No evidence of obstruction. No associated fat stranding.
Liver, spleen, adrenal glands, pancreas, right kidney and gallbladder all have a normal appearance. The appendix is visualized and is of a normal appearance. Aside from colonic fecal loading the bowel is unremarkable. No free fluid or free gas.
Conclusion:
Ureteritis and cystitis. Mild prominence of the renal pelvis on the left, without evidence of definite obstruction or established lobar nephronia or renal abscess.
Case Discussion
Ureteritis refers to inflammation of the ureters and it can have a number of causes. The most common, as in this case, is from an ascending urinary tract infection (Staphylococcus saprophyticus was isolated from the urine culture).
Unsurprisingly cystitis is also demonstrated in this case.
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