What would be expected in the physical examination of a patient with right-sided ureteral obstruction?

In the case of right-sided ureteral obstruction, unilateral flank tenderness is the expected finding during a physical examination. This tenderness occurs because the obstruction leads to increased pressure in the affected ureter and surrounding structures, resulting in inflammation and pain in the flank region on the same side as the obstruction.

As the obstruction prevents urine from flowing from the kidney to the bladder, the kidney becomes distended, which can cause localized pain and tenderness upon examination. This flank tenderness is often a key indicator of ureteral obstruction rather than referred pain, which would typically manifest in a different pattern, or signs of peritoneal irritation, which would suggest a different pathology. Additionally, decreased bowel sounds typically reflect bowel obstruction or ileus rather than ureteral obstruction. Thus, unilateral flank tenderness is a definitive sign that correlates with the presence of a right-sided ureteral obstruction and helps clinicians identify and manage the underlying condition effectively.