– 10 year old FS DSH anorexia, vomiting
– good body condition on physical exam – abdomen soft
– bloodwork showed marked azotemia, hyperphosphatemia, granulocytosis (in house Lab)
– urine SG 1.016 and neutrophils on sediment – culture pending
– x-rays possible renal mineralization R kidney
– u/s: normal kidney size, good cortico-medullary distinction but I am having a hard time determining what is going on in the renal pelvis especially on the right side – is there pyelectasia/hydronephrosis or not? Inflamed renal pelvis? pyelonephritis?
– 10 year old FS DSH anorexia, vomiting
– good body condition on physical exam – abdomen soft
– bloodwork showed marked azotemia, hyperphosphatemia, granulocytosis (in house Lab)
– urine SG 1.016 and neutrophils on sediment – culture pending
– x-rays possible renal mineralization R kidney
– u/s: normal kidney size, good cortico-medullary distinction but I am having a hard time determining what is going on in the renal pelvis especially on the right side – is there pyelectasia/hydronephrosis or not? Inflamed renal pelvis? pyelonephritis?
– urinary bladder normal – ureters not identified
1. What do you think about kidney lesions? (Note: the third kidney image down is actually the left kidney, not the right – sorry mislabelled)
2. As a side, the gall bladder -at first I thought severe bile duct obstruction but now I am wondering if this is just an odd shaped GB – what do you think?
Comments
Looks like she is moving
Looks like she is moving stones within the kidney and perhaps moved some through already. The pelvic fat is ill defined suggestive for inflammation and the stones have ill defined fat as well around them. the kidneys appear swollen as well. if this theory fits she should respond well to an acute rf iv protocol and numbers tend to normalize quickly. Infectious always possible, bp and culture applicable. Since she is a female stones pop out pretty easily.
Looks like she is moving
Looks like she is moving stones within the kidney and perhaps moved some through already. The pelvic fat is ill defined suggestive for inflammation and the stones have ill defined fat as well around them. the kidneys appear swollen as well. if this theory fits she should respond well to an acute rf iv protocol and numbers tend to normalize quickly. Infectious always possible, bp and culture applicable. Since she is a female stones pop out pretty easily.
Looks like a vestigial Gb
Looks like a vestigial Gb remnant causing that look but the cystic duct and beginning of the cbd is a little enlarged but if anorexic from the renal issue then the Gb may be big from that. Don’t think its pathological.
Looks like a vestigial Gb
Looks like a vestigial Gb remnant causing that look but the cystic duct and beginning of the cbd is a little enlarged but if anorexic from the renal issue then the Gb may be big from that. Don’t think its pathological.
Treated with IV fluids,
Treated with IV fluids, antibiotics and famotidine and now eating and going home. Azotemia dramatically improved but still present. Still awaiting results of urine culture.
I wonder if this is a “tri-lobed” gall bladder?
Thanks Eric!
Treated with IV fluids,
Treated with IV fluids, antibiotics and famotidine and now eating and going home. Azotemia dramatically improved but still present. Still awaiting results of urine culture.
I wonder if this is a “tri-lobed” gall bladder?
Thanks Eric!
yep classic for temporary
yep classic for temporary stone obstruction…i think bilobed and distended cystic duct on the gb
yep classic for temporary
yep classic for temporary stone obstruction…i think bilobed and distended cystic duct on the gb