History: A 61-year-old with left ureteral obstruction. Question of crossing vessel.

Multiple thin cuts were obtained during IV contrast administration in the abdomen going through the regions of the kidneys. No oral contrast was given. Patient has marked left hydronephrosis and left hydroureter. There are multiple calcifications seen consistent with renal stones noted in the left kidney. There is a left ureteral stent noted in the upper ureter which is distended. From the images it appears that the patient has a single left renal artery. I see the main renal artery dividing into the anterior-posterior branch. The posterior branch goes around the back of the left pelvis into the kidney at the upper portion. The left renal vein is noted to be interior to the left pelvis. Please note that the images end at the upper ureter where patient's left ureteral stent superior loop was noted. As a result the only crossing vessel is the posterior branch of the left main renal artery which is behind the left pelvis. In the right kidney a small cortical renal cyst is seen.

The visualized portions of the liver and spleen, gallbladder, pancreas and adrenals are grossly within normal limits.

There is mild thickening of the left adrenal gland. Clinical correlation is recommended.

Impression

Marked left hydronephrosis with multiple stones seen. The dilatation extends to the upper ureter. Upper loop of the left ureteral stent is noted. The left posterior branch of the renal artery crosses behind the left renal pelvis. No other crossing vessels are seen. There is mild thickening of the left adrenal gland. Clinical correlation is recommended.

EP/wf

*** Preliminary Report ***

Dictating Physician: POON, EDWARD

Transcribed Date: 04/17/2002 11 :52