CTAP was done showing
(1)A 7mm VUJ stone causing upstream severe hydroureteronephrosis and delayed enhancement and excretion of the left kidney.Superimposed ureteritis is suspected and correlation with serum and urine biochemistry is suggested.
(2)Severe right hydronephrosis associated with cortical loss is probably chronic.Several right lower pole stones are noted.The cause is not shown on the current CT as a delayed scan to opacity the ureter was not done.
(3)Large teratoma in the left adnexa with no CT evidence of torsion.The right ovary is not confidently identified.
(4)Bulky uterus,likely enlarged by fibroids.
Impression is that the left sided teratoma is causing hydronephrosis of the left kidney.She was also referred to Uro for the renal calculi with hydronephrosis who suggested laser lithotripsy during the same sitting as removal of the ovarian tumour if patient wants surgery.Uro suggests to refer to Uro at KKH if pt is for surgery.
You guys are really great and explain things in a much easier to understand way than my mum's doctors.So glad that I have found this site.:)
Most Helpful Guy
For someone with lower abdominal pain, workout includes an ultrasound and a CT.
On the left, there recent swelling of the kidney due to some swelling of the ureter, caused by a possible combination of a ureter stone incompletely blocking it and compression from the outside by an ovarian teratoma (typically noncancerous).
On the right, there is long-standing swelling of the kidney with some old damage, cause is not clear because they didn't check the emptying of that ureter and they weren't able to see the right ovary.
She also has gallstones (common in women over 40) which don't seem to be causing her the pain (no swelling of gallbladder or bile ducts were noted). The enlarged uterus (likely to be caused by fibroids, noncancerous growths, in older women) was not noted to be compressing the ureter (this can happen so they need to look for it).
Treatment is to use sonic waves to break the stone in the left ureter to bits, and in the same surgery (if it's okay with your mom) they want to completely cut out the teratoma to relieve the ureter of compression, and also to take a look and make sure the tumor hasn't spread (10% chance, so unlikely) and to biopsy the tumor and see it's potential to be dangerous or not.
They will want to follow up with her after removing the tumor to see if it comes back at all (blood tests and imaging) for some time before she is in the clear.
Hope this helps!
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