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Ultrasound showed mild left complex hydronephrosis with internal debris. What does this mean?

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My daughter, 15 years old, just had a repeat renal/bladder ultrasound. The initial u/s showed a 10 mm hypoechoic avascular "cyst". The repeat u/s, one week later, showed hydro, pyelo, the cyst had gotten bigger and said it was "mild left complex hydronephrosis with XXXXXXX debris. Also, a heterogeneous collection near left kidney which has low level XXXXXXX echoes. No XXXXXXX vascularity is noted. Left renal hydronephrosis and perinephric complex collection. Abscess is not completely excluded, particularly given the patients history of flank pain and pyuria. Pyelonephrosis should also be excluded given the debris in the collecting system XXXXXXX
Posted Tue, 22 Jan 2013 in Kidney Conditions
Answered by Dr. Michelle Gibson James 2 hours later
Hi, thanks for using healthcare magic

Left hydronephrosis means widenening of the renal calyces and renal pelvis as a result of an obstruction that is usually distal (beyond) the renal pelvis.
The renal calyces are the parts of the kidneys that are involved in the collection of urine, they lead into the renal pelvis which would then lead into the ureter.The ureter takes the urine to the bladder.
Heterogeneous collection means that when they looked at the mass/fluid that has collected near the left kidney- the parts of it were dissimilar.In a homogeneous collection or mass, all the parts of the area look basically the same.
This collection is said to be perinephric in the conclusion which means that it is outside the kidney. Because it is outside the kidney it may be obstructing the ureter resulting in the hydronephrosis.
No XXXXXXX vascularity noted means that there were no excess blood supply going to the collection that was seen.

As stated in the conclusion of the report, with the history of pain and purulent discharge in the urine, the result could be consistent with an abscess collection in the area of the kidneys.
The definitive treatment of an abscess is incision and drainage along with the use of antibiotic therapy.

Hope this helps and your daughter feels better soon,feel free to ask any additional questions
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