1. Chief Concern: Abdominal Pain, Nephrotic Syndrome, rule out Pyelonephritis or Renal Abscess

2. Any signs of Nephrotic Syndrome, Pyelonephritis, or Renal Abcess?

3. What has changed from the previous image?

4. Continuation of CT (distal)

5. Causes and Treatment of Renal Vein Thrombosis
Causes, incidence, and risk factors:
Renal vein thrombosis is a fairly uncommon situation that may happen after trauma to the abdomen or back, or it may occur because of a tumor, stricture (scar formation), or other blockage of the vein. It may be associated with nephrotic syndrome .

6. Impression:
Partial bilateral renal vein thrombosis with extension of the thrombus into the IVC.  This ascends as high as the portal confluence, but does not extend to the hepatic IVC. The renal vein thrombosis contributes to a delayed, heterogeneous nephrogram, particularly involving the left upper and lower renal poles.
Anasarca with bilateral pleural effusions, moderate ascites and diffuse body wall edema
Pelvic adenopathy is likely reactive.