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BMC Urol. 2015 Jul 2;15:61. doi: 10.1186/s12894-015-0054-1.

Renal vein thrombosis mimicking urinary calculus: a dilemma of diagnosis.

Author information

1
Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, 310003, Hangzhou, China. wangym_in@163.com.
2
Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, 310003, Hangzhou, China. chensw123@126.com.
3
Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, 310003, Hangzhou, China. wangw2002@163.com.
4
Sidney kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, 21128, Baltimore, USA. jiliu15@jhmi.edu.
5
Department of Urology, the First Affiliated Hospital of Medical College, Zhejiang University, No. 79 Qing Chun Road, 310003, Hangzhou, China. jinbaiye1964@aliyun.com.

Abstract

BACKGROUND:

Renal vein thrombosis (RVT) with flank pain, and hematuria, is often mistaken with renal colic originating from ureteric or renal calculus. Especially in young and otherwise healthy patients, clinicians are easily misled by clinical presentation and calcified RVT.

CASE PRESENTATION:

A 38-year-old woman presented with flank pain and hematuria suggestive of renal calculus on ultrasound. She underwent extracorporeal shock wave lithotripsy that failed, leading to the recommendation that percutaneous lithotomy was necessary to remove the renal calculus. In preoperative view of the unusual shape of the calculus without hydronephrosis, noncontrast computed tomography was taken and demonstrated left ureteric calculus. However computed tomography angiography revealed, to our surprise, a calcified RVT that was initially thought to be a urinary calculus.

CONCLUSION:

This case shows that a calcified RVT might mimic a urinary calculus on conventional ultrasonography and ureteric calculus on noncontrast computed tomography. Subsequent computed tomography angiography disclosed that a calcified RVT caused the imaging findings, thus creating a potentially dangerous clinical pitfall. Hence, it is suggested that the possibility of a RVT needs to be considered in the differential diagnosis whenever one detects an uncommon shape for a urinary calculus.

PMID:
26133978
PMCID:
PMC4488058
DOI:
10.1186/s12894-015-0054-1
[Indexed for MEDLINE]
Free PMC Article

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