What is the significance of mild left hydroureteronephrosis secondary to a 2mm calculus at the left ureterovesical junction on a CT scan of the abdomen and pelvis?

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Differential Diagnosis for Mild Left Hydroureteronephrosis

  • Single most likely diagnosis
    • Ureteral obstruction due to a 2mm kidney stone (urolithiasis) at the left ureterovesical junction: This is the most direct cause given the CT findings, as the stone's location at the ureterovesical junction can easily obstruct urine flow, leading to hydroureteronephrosis.
  • Other Likely diagnoses
    • Blood clot obstruction: A blood clot could potentially obstruct the ureter at the same location, causing similar symptoms and findings.
    • Ureteral stricture: A narrowing of the ureter, which could be due to various causes including previous surgery, instrumentation, or disease, could also lead to obstruction and subsequent hydroureteronephrosis.
    • External compression (e.g., from a tumor or lymphadenopathy): Although less common, external compression of the ureter at the ureterovesical junction could cause obstruction.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • Ureteral tumor: A tumor in the ureter could cause obstruction and would have significant implications for treatment and prognosis.
    • Retroperitoneal fibrosis: A rare condition characterized by the proliferation of fibrous tissue in the retroperitoneum, which can encase and obstruct the ureters.
    • Invasive pelvic malignancy: Cancers such as cervical, prostate, or colorectal cancer can invade the ureters and cause obstruction.
  • Rare diagnoses
    • Congenital ureteral anomalies (e.g., ureteral duplication, ectopic ureter): These conditions could potentially cause or contribute to the obstruction, especially if associated with other anomalies.
    • Inflammatory or infectious processes (e.g., tuberculosis, schistosomiasis): Certain infections can cause ureteral strictures or obstruction, although these are less common in many parts of the world.
    • Vascular abnormalities (e.g., ureteral vascular compression): Rare vascular anomalies could potentially compress the ureter and cause obstruction.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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