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 in the ureter could cause similar symptoms and findings, especially if there's an underlying condition like nephrolithiasis or urinary tract infection.
- Ureteral stricture: Narrowing of the ureter, which could be due to various causes including previous surgery, infection, or inflammation, could also lead to obstruction and subsequent hydroureteronephrosis.
- External compression (e.g., from a tumor or lymphadenopathy): Though 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, though rare, could cause obstruction and would have significant implications for treatment and prognosis.
- Retroperitoneal fibrosis: A condition where fibrotic tissue forms in the retroperitoneum and can encase and obstruct the ureters, which could lead to severe consequences if not addressed.
- Vascular obstruction (e.g., from an abdominal aortic aneurysm or other vascular abnormalities): Though rare, vascular causes of ureteral obstruction could have severe and immediate consequences.
- Rare diagnoses
- Congenital ureteral anomalies (e.g., ureteral duplication, ectopic ureter): These conditions could potentially cause obstruction, especially if associated with other anomalies like ureterocele.
- Endometriosis involving the ureter: Rarely, endometriosis can cause external compression or invasion of the ureter, leading to obstruction.
- Inflammatory or infectious processes (e.g., tuberculosis, schistosomiasis): In certain geographic areas or patient populations, these conditions could cause ureteral obstruction and subsequent hydroureteronephrosis.