A Case Report of Dextranomer/Hyaluronic Acid Copolymer (DefluxTM) Implant Seen on CT as Distal Ureteral Calcification: How to Differentiate between Distal Ureteral Stones from DefluxTM?

Injection of dextranomer/hyaluronic acid copolymer (DefluxTM or Dx/HA) has become a common urologic procedure for treatment of low to intermediate grade vesicoureteral reflux. We report a rare case of a child with history of DefluxTM injection presenting to our emergency department with abdominal pain and non-contrast CT findings of a distal ureteral calcification mimicking a ureteral stone. Emergency physicians and consulting urologists need to be aware of this phenomenon and consider calcified Deflux as a potential differential diagnosis when evaluating young adults with abdominal pain and CT findings suggestive of distal ureteral calcification.