Presentation
Severe left flank pain and fever.
Patient Data
Proximal left ureteric stone with gross hydronephrosis.
Cortical thinning of the left kidney.
After clinico-radiolgical discussion nephrostomy insertion performed for a initial temporising treatment.
Control film with puncture needle in the lower pole calyx and a proximal ureteric stone.
Nephrostogram confirming ideal puncture and hydronphrosis due to obstructing stone.
Definitive treatment with ureteroscopy and ureteric stent insertion. Post procedure film prior to nephrostomy removal.
Following stone clearance, a left ureteric stent and nephrostomy remain in situ.
Case Discussion
In some circumstances, especially a infected system a nephrostomy may be initial inserted prior to definitive treatment for an obstructing stone.
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