<p>Both kidneys are normal in their position, shape and outline. The left kidney is however enlarged. They measure 95mm and 147mm in their respective bipolar lengths on the right and left sides. The left shows moderate to severe dilatation of its pelvi-calyceal system. No calculus is seen.&nbsp;</p><p>The liver is normal in size with uniform parenchymal echo pattern. No focal hepatic mass lesion is seen. The gall bladder is demonstrated with good mucosal wall coating, no stone or sludge seen within it. The intra-hepatic biliary system and the common bile duct are within normal limits. The pancreas and the para aortic regions are within normal limits. The spleen is normal in size and parenchyma echo pattern.</p><p>No intra-abdominal mass lesion or ascites demonstrated.</p><p>The visualized bowel loops are within normal limits.</p><p>The urinary bladder is well distended with urine and shows normal mucosal wall thickness. No sludge or calculus seen.</p><p>The uterus, both adnaxae and POD are within normal limitys.</p><p><strong>&nbsp;</strong></p><p><strong>Conclusion</strong>: Moderate-severe left hydronephrosis ?PUJ obstruction</p><p>NB: CT IVU is advised for further evaluation.</p>