July 21, 2012


 Longitudinal ultrasound image of the right kidney shows moderate right hydroureteronephrosis (arrows) with internal debris.

Longitudinal image of the right ureter (arrows) shows a stone (arrowhead) in the distal ureter causing proximal hydroureter. 


  • Bacterial infection of urine associated with ureteral obstruction, AKA infected hydronephrosis. Accumulation of pus in the renal pelvis and calices of the kidney
  • Common causes are ureteric obstruction by stone and ureteropelvic junction (UPJ) obstruction
  • Septic patients with high fever, flank pain and tenderness
  • Any febrile patients with hydronephrosis should be suspected of having pyonephrosis
  • Ultrasound: echogenic urine and debris in the hydronephrotic kidney
  • Prompt drainage essential 
Hodler J, Von Schulthess GK, Zollikofer ChL. Diseases of the abdomen and pelvis 2010-2013

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