A middle-aged male with a past medical history of nephrolithiasis presented with left flank pain. He looked uncomfortable, was nauseas and vomiting.
POCUS Renal shows severe hydronephrosis on the left. There are signs of obstruction as the renal pelvis backs up with fluid from a likely obstructing kidney stone distal to this point. This is severe hydronephrosis, the renal pyramids are no longer identifiable. The hypoechoic renal pelvis has expanded almost to the periphery of the kidney making the kidney architecture difficult to identify. The right kidney was normal. Nice job Jorge! Urology was consulted, but the patient did actually pass this stone and is doing well.
SONO Pearl: If the demographic is appropriate, it is likely wise to think of renal and aortic ultrasound exams as something that should be done together. Aortic abdominal aneurisms (AAA) are often misdiagnosed as kidney stones.