A 57-year-old man presented with chief complaints of hematuria and lethargy. He has experienced same symptoms intermittently over the last month, with occasional macroscopic blood seen when passing urine. He complains of an increase in frequency and nocturia without dysuria. Social history: Ex-smoker, alcoholic. Clinical Examination: He is afebrile and in no obvious discomfort. Cardiovascular and respiratory examinations are normal, but on abdominal examination, there is fullness at both renal angles and mild discomfort on deep palpation.
Laboratory investigations: Blood results reveal a creatinine of 515 μmol/L with normal urea and potassium. A routine blood result from 3 months previously recorded his creatinine as 72 μmol/L. His inflammatory markers are not elevated and a blood gas does not demonstrate any acidosis. Ultrasound images are given below. What does the ultrasound reports…
