PTU - Polskie Towarzystwo Urologiczne

Diagnostic mistakes of radiological urolithiasis visualization
Artykuł opublikowany w Urologii Polskiej 2008/61/2.

autorzy

Mykola Pasichnyk, Serhiy Pasichnyk, Aleksander Shulyak
Danylo Halytsky Lviv National Medical University, Department of Urology, Ukraine

Clinical presentation
• Age: 40 years
• Gender: male
• Complaints: Acute renal colic
• History of disease: acutely admitted by ambulance to the Rivne Regional Diagnostic Center (Ukraine)
• History of life: before hospitalization this patient had no complaints
• Occupation: worker of the porcine farm

Results of clinical examination • Pain in right flank, positive Merphy’s sign on the right
• Blood cell count: Hb– 122 g/L, Er– 3x1012/L, L– 6.8x109/L, ESR– 9 mm/h
• Differentional blood cell count: eosinophilia (9%).
• Urinalysis: normal
• Blood biochemistry: normal
• Blood coagulation test: normal

Ultrasonography:
• Right kidney: parenchyma normal, hydroureteronephrosis to the upper third of ureter (its diameter 9 mm) without any stone.
• Left kidney, liver, spleen, regional lymphatic nodesnormal.
• Treatment: specific drugs against cystocercosis according to the consultation of infectious disease specialist and ureteral stenting

Conclusions of CT

Multiple calcifications in the soft tissues. Hydroureteronephrosis to the upper third of the ureter on the right caused by the periureteral calcification (diameter about 7 mm).

Management

• This particular patient refused any treatment
• Follow-up of this case was not possible
Questions • What is your diagnosis?
• What additional tests would you prescribe?
• What management would you suggest?

Our diagnosis

• Cystocercosis?

What is cysticercosis?

- Similarly to other parasitic diseases, cysticercosis is caused by the use of contaminated food or water. Sometimes autoinfection of the patient already infected with a tape worm is noted. Unlike in the brain (or eyes), in the visceral organs cysticercus is surrounded by the fibrous capsule, but remains alive for several years.

Holger Pettersson, MD Professor of Radiology, University Hospital, Lund, Sweden, 1995.

adres autorów

Aleksander Shulyak
Boguna 6\6
Lviv-13
Ukraine, 79013
sasha@meduniv.lviv.ua