ARRS Case of the Week

GENITOURINARY IMAGING: Kidneys, Ureter, and Bladder

Case Author: Frederico F. Souza, MD, University of Mississippi Medical Center


44-year-old man with 3 days of left flank pain

Imaging Findings

Unenhanced CT scan of the abdomen (A) shows an enlarged left kidney with mild-tomoderate hydronephrosis and perinephric standing. Unenhanced CT scan of the abdomen obtained at the level of the spleen (B) shows fluid in the retroperitoneal space collected mainly along the left anterior pararenal fascia. Unenhanced CT scan (C) of the pelvis shows a 5-mm calculus impacted in the distal ureter approximately 1 cm above the left ureterovesical junction. Delayed CT image (D) obtained 10 minutes after contrast administration shows extravasation of excreted contrast material from the left collecting system into the perinephric space.


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