enlarged right kidney

[lamont3]

GP ordered an ultrasound to lok at gallbladder, and sent me to a surgeon, who in turn said the right kidney was dilated and that was a bigger concern. He ordered an IVP and CT scan and am still waiting for the results now a week later. Any thoughts as to what would cause the dilation? I have almost constant twisting pain deep in the lower right quadrant and back pain with movement (not really flank pain), and feel very full after eating (likely the gallbladder).

[Vanessa Lacuesta]

Hi,

Taking soda may cause a sensation of bloatedess but this should only be temporary. In some cases, peptic ulcer disease and dyspepsia need to be ruled out.But you had an upper GI series done ( is this correct?) and it came back normal. I do not think the soda causes your symptoms.Your tests did not show anything significant. I would like to think that a musculoskeletal cause may also play a role here.Your spine disorder may be causing referred pain.

I know that you have been through a lot but your tests all came back fine. This should offer some relief. Shift your focus on other things now.Were you given any medications for the pain? Try to engage in mild to moderate exercises and spend more time with family and friends.Keep a healthy diet.Avoid spicy food and too much soda.

[lamont3]

I have noticed the pain goes from a 3 to a 5 after drinking soda.The tests showed no obstruction or stones so why does drinking 6-8 oz. of soda consistently cause a worsening of the pain? I drank nothing but soda for years and quit it completely after two major surgeries last year. I now have a glass in the evening and have major bloating in the upper abdomin as well. I know I shouldn't drink it at all, but can it really be the sole cause?

[Vanessa Lacuesta]

Hi,


Your test results do offer a degree of  relief. A referral to a spine specialist may be able to help guide you in managing the spine disease noted in your scan.Physical therapy sessions may also be beneficial to help alleviate the pain. Avoid straining and bending and refrain from any strenuous exercises until you have been properly assessed.Avoid fatty food and drink lots of water everyday.Swimming and brisk walking may  be beneficial.

[lamont3]

Report states: Kidneys are normal in size, position and configuration, with no renal masses.There is moderate dilatation of the right pelvicaliceal system and the ureater down to th UV junction, but with good emptying in the post-void film. his would indicate nonobstructive dilatation and is probably realated to old infection. The finding was not impressive on the previous CT scan from 10/27/06.----The gallbladder is visualized and is known to contain a small amount of sludge on the ultrasound examination from 2/4/08.--L5-S1 disc disease( that explains the back pain!). --(Impression: Nonobstructive mild to moderate dilataion of the right pelvicaliceal system and the ureter, which is heavily favored to be residual from an old infection.---(All the other observations were normal) ----- So I feel better seeing the facts.The pain remains, some days worse than others, but I know why now.

[Vanessa Lacuesta]

Hi,

One has to differentiate between enlarged kidneys per se or enlargement of the renal pelvices which may be due to hydronephrosis given that the enlargement may be due to an obstruction secondary to a stone or some structural abnormalities. Cysts in the kidney especially multiple cysts may make it look enlarged but this may readily be differentiated from that of enlargement secondary to a hydronephrosis.

Let us wait for the scan results as the type of management will be determined from there.

[lamont3]

I actually did call earlier today and ask for a copy of the report and the receptionist said I could get the disc from the hospital. I have an appt with a GI dr next month (a follow up from the colonoscopy) and thought I'd just take all these results with me. I will try the apple fast. I also heard beets are good to clear things out. Thanks.

[karajo]

What test came back functional?

There could be an intermittant ureteopelvic junction obstruction and the IVP be functional.  Get copies of your test - not just the results.  Get the radiologist report and get the film put on a disc where you can view it on your computer.  My dr. told me my IVP was normal, but the radiologist report said otherwise.  I would've never known if I had not gone by the hospital and requested the report.  

try this web site on intermittent hydronephrosis secondary to ureteropelvie junction obstruction :
http://pediatrics.aappublications.org/cgi/content/full/117/1/139

or you can do a search entering IVP images, or CT images of hydronephrosis

FYI, that sludge in the gallbladder is not good. Drink apple juice and eat apples and see if the nausea and pain goes away.  I mean go on an apple/juice fast for a day.  Let me know.

[lamont3]

Got results today from scans and they said everything is "functional". So I guess thats that. I still wonder why the pain continues, but at least I know its not serious. An adhesion I suppose. Thanks for all your help!

[lamont3]

Ultrasound showed only sludge in the gallbladder. I will call today and see if results are in. I live in a very rural area and the little hospital is slow in this. A year and a half ago I had a temp colostomy for perforated colon (diverticulitis) which was successfully reversed last year. In Dec. I went to a GI dr who ordered upper GI series (small sliding hiatul hernia, not serious), with small bowel follow thru (20 min!) and did a colonoscopy. He removed a small polyp and found small diverticuli, but I have heard nothing from him since that day. The office said no news is good news when I called. I do have an appt. in a couple weeks with him. I was having more pain so I went to my family dr and hence the ultrasound. I think in all these tests there would be a definitive answer. I hate food anymore! lol

[karajo]

What did the ultrasound say about the gallbladder?
You could be having problems in several areas.  

You certainly should've heard from the IVP and CT by now.  I would call and see what the hold up is.  

Dilated kidney could be:
hydronephrosis - caused by a stone, uretopelvic junction obstruction, or floating kidney
(UPJ - where the kidney and ureter meet)

I'm assuming this is the renal pelvis that is dilated.

Other test for kidney funtion:
diuretic renal gram (stress test for the kideny)
retrograde pyelogram (shows explicit detail of the urter and kideny, but doesn't stress the kidney or ureter out to show how it performs under normal everyday living.)

drink lots of water.
You're in my prayers