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What Does Right Sided Dilatation Of Pelicalyceal System Mean?

Posted on Wed, 8 Oct 2014

Question: Right Kidney :--Mild dilatation of pelvicalyceal system is seen on the right side with few internal echoes. Right ureter is dilated in its upper part .lower part is obscured by bowel gases. Distal most end is slightly inflamed, no obvious calculus seen. There is no evidence of mass lesion. No perinephric collection noted. A calculus of size 8.7mm is seen in right lower calyx.

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
It is due to blocked lower end of ureter

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day,

Dear XXXXXXX

Right sided dilatation of Pelicalyceal system along with right ureter dilatation is likely to be stone impacted in lower end of ureter. It has likely slipped and has caused the lower end of ureter to be inflamed. Internal echoes suggest possibility of pus inside.

Further management requires clinico-radiological correlation.

Kindly let me know if you need any further assistance.

Take Care

Best Regards
Dr Deepak Kishore
Consultant Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (14 minutes later)

Please give me opinion about it in detail ....Please

Answered by Dr. Deepak Kishore Kaltari (2 hours later)

Brief Answer:
Will require Antibiotics

Detailed Answer:
Hi
Dear XXXXXXX

When there are multiple stones in the kidney, few of them can slip into the ureter and obstruct it. This obstruction in ureter can cause inadequate drainage of urine, leading to increased back pressure . This back pressure has caused abnormal dilatation of Ureter, Renal Pelvis and collecting ducts causing Hydronephrosis and Hydroureter.
The stagnation in the urinary tract has lead to internal echoes which are due to presence of pus.

The diagnosis goes in favour of Hydronephrosis/Hydroureter secondary to Renal Calculi .
Further management will depend on symptoms. Based on this , it is very much likely fever could be present. I would suggest the following

1. Consultation with Urologist
2. Intravenous antibiotics
3. If the fever still persists you may require Retrograde Ureteroscopy and stunting of ureter to aid in drainage of urinary tract.

Do get back to me with details of symptoms and duration.
Also let me know other investigation done so far.

Awaiting your response

Regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (33 minutes later)

Thanks sir ...1.Dr give me Tazomac ( Piperacillin and Tazobactam for injection USP ) 4.5 g I.V morning and evening for five days
2. Multivitamins with chromium, zinc and selenium Tablets for two times
3. Potassium citrate and citric acid oral solution USP for two times
4. TAMCONTIN 0.2 (Controlled release Tablets of Tamsulosin Hydrochloride) at night ....Please give me your s experienced opinion about it ...Please
I m suffering from urine passing problem

Answered by Dr. Deepak Kishore Kaltari (6 hours later)

Brief Answer:
If there is no fever then not to worry

Detailed Answer:
Dear Mr XXXXXXX

If there is no fever at present then there is no cause for concern. If the symptoms persists then repeat Ultrasound will be required for further assessment.
Stone of 8.4 mm in Kidney is likely o pass spontaneously.

I would suggest the following

1. Ensure water intake of at least 3 litre a day
2. Urinary analgesic like Phenazopyridine will relieve the urinary complaints

Do keep me updated about progress

Regards
Deepak

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar