PMC9806547_01
Unenhanced computed tomography scan of the kidneys, ureters, and bladder demonstrating hyperdense calcification at left vesicoureteric junction
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FIG1
Unenhanced computed tomography scan of the kidneys, ureters, and bladder (CT KUB) demonstrated a high-density (19 mm x 8mm) calcification at the left vesicoureteric junction (Figure 1) with significant left ureterohydronephrosis (Figure 2).
Unenhanced computed tomography scan of the kidneys, ureters, and bladder demonstrating left ureterohydronephrosis
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FIG2
Unenhanced computed tomography scan of the kidneys, ureters, and bladder (CT KUB) demonstrated a high-density (19 mm x 8mm) calcification at the left vesicoureteric junction (Figure 1) with significant left ureterohydronephrosis (Figure 2).
DMSA scan showing homogenous isotope uptake without focal scarring seen in both kidneys. DMSA: Technetium-99m dimercaptosuccinic acid
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FIG3
Differential cortical tracer uptake of the left kidney and the right kidney was 51.45% and 48.55%, respectively (Figure 3).
Pre-operative MAG-3 renogram. Left kidney (dotted blue line) illustrating an obstructive pattern of drainage with improvement in excretion with a diuretic (solid blue line), in comparison to the right kidney (solid pink line). MAG-3: Technetium-99m mercaptoacetyltriglycine
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FIG4
The dynamic images reflected dilatation of the left pelvi-calyceal system and the entire length of the left ureter, which persisted 70 minutes post micturition (Figure 4). 
Retrograde pyelogram illustrating dilatation of left pelvi-calyceal system and ureter
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FIG5
A retrograde pyelogram demonstrated a grossly dilated left pelvi-calyceal system and ureter (Figure 5).
Identification of the left ureter by a yellow loop
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FIG6
A lower midline incision was made and the left ureter containing the previously inserted ureteric stent was identified (Figure 6).
Computed tomography urogram showing resolution of the left hydroureteronephrosis
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FIG7
As shown in Figure 7, the previously observed left ureterohydronephrosis markedly improved.
Postoperative MAG-3 renogram. MAG-3: Technetium-99m mercaptoacetyltriglycine
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FIG8
In comparison to the preoperative MAG-3 renogram in which the left kidney failed to drain until diuretic administration, the postoperative MAG-3 renogram revealed slow but immediate excretion followed by an exceptional response to a diuretic (Figure 8).