Bilateral calcular pelviureteric junction obstruction

Case contributed by Jeremy Lek


Presented to ED with new onset status epilepticus. Palpable organomegaly.

Patient Data

Age: 55 years
Gender: Male

Bilateral gross hydronephrosis, bilateral pelviureteric junction calculi, severely effaced renal cortex, with multiple intrarenal calculi. The appearance suggests a long-standing calculus disease and chronic obstruction.

The right calculus is 18 x 9 x 11 mm.

The left calculus is 9 x 6 x 14 mm.

Moderate cardiomegaly, small pericardial effusion.

Bibasal pulmonary segmental collapse; left greater than right.

Endotracheal tube, nasogastric tube, and indwelling urinary catheter, all appropriately positioned.

Case Discussion

This case demonstrates an atypical presentation of chronic bilateral urolithiasis

Patient presented with complications of renal failure: uremic encephalopathy and uremic gastritis without any symptoms prior. 

Patient received urgent haemodialysis and filtration, and subsequently urological intervention with the insertion of bilateral DJ stents.

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