CT findings in a patient taking an angiotensin-converting enzyme (ACE) inhibitor help in the diagnosis and subsequent treatment of ACE inhibitor-induced visceral angioedema.
Symptomatic urolithiasis in the pregnant patient presents a diagnostic challenge to the clinician and radiologist. The presentation can mimic multiple other disease processes, including pathology unique to the gravid patient. The objective of this article was to describe challenges in sonographic imaging of urolithiasis in pregnant patients.Ultrasonography is the imaging modality of choice in pregnant patients with suspected urolithiasis. Signs of urinary collecting system obstruction that are usually reliable in nonpregnant patients may not be reliable in pregnant patients. Normal physiological changes of pregnancy can mimic ureteral obstruction on imaging. Utilization of endovaginal scanning techniques and intrarenal resistive index determination may help improve the diagnostic accuracy of ultrasound in symptomatic patients.
Imaging Findings US of the kidneys revealed mild left hydronephrosis and bilateral renal calyceal echogenicities with shadowing. These were initially thought to be calculi (Fig 1). Unenhanced CT of the abdomen and pelvis revealed mild bilateral hydroureter and hydronephrosis, with curvilinear calcifi cations involving the urothelium of the renal pelves and calyces (Fig 2). These CT fi ndings were not seen at CT performed approximately 1 year previously. On the basis of these radiologic fi ndings, a presumptive diagnosis of alkaline-encrusted pyelitis was made.
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