Case contributed by Dr Shervin Sharifkashani


Colicky abdominal pain, nausea, and vomiting for two days.

Patient Data

Age: 25 years
Gender: Female

A calculus with coronal height up to 6 mm in the left side ureter distal segment proximal part with hydroureteronephrosis upstream is seen. Another calculus with coronal height up to 4 mm in the left kidney lower pole is also seen. The spleen with coronal width up to 150 x 65 mm is within the upper limit of normal size. A few small phleboliths on the left side of the pelvic cavity are seen.

Case Discussion

The case illustrates obstructive distal ureterolithiasis and hydroureteronephrosis upstream. Pelvic phleboliths can mimic the distal ureteric calculus and some characteristics including rounded shape, central lucency1, and presence of comet tail sign can differentiate the phleboliths from calculus in the majority of cases.

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