Scout film demonstrates the presence of collection of approximately 20 small rounded calcifications in the left abdomen ranging between 2-4 mm in size. There are also two other smaller groups of rounded calcifications in the left abdomen slightly more superior in the lateral. Delayed films were obtained following intravenous administration of nonionic contrast. Both kidneys are promptly opacified. The left kidney is enlarged and is markedly hydronephrotic. The right kidney is of normal size. There is an extrarenal pelvis on the right. There is massive distention of the left collecting system. The above described calcifications are all in the projection of the left collecting system. The largest collection is located near the ureteropelvic junction. Examination was taken after four hours after injection. At no time was there any opacification of the left ureter. The right ureter is of normal caliber. The urinary bladder distends normally with no intravesicular mass identified. There is a moderate size post void residual within the urinary bladder.

Impression

Enlarged and severely hydronephrotic left kidney. There is a large collection of small stones identified in the left renal pelvis near the ureteropelvic junction which appear to be resulting in obstruction.

Signed: 12/19/2001 CIFERS, ROBERT W, MD