Percutaneous nephrolithotomy

Case contributed by Andrew Murphy

Presentation

Percutaneous nephrolithotomy for removal of kidney stones.

Patient Data

Age: 65 years
Gender: Male
X-ray

Pre operative imaging

2cm left renal pelvic stone.

No ureteric stone.

4cm radio-opacity projected over the midline of the pelvic, likely a bladder stone.

Pre-operative CT-KUB performed elsewhere.   Not available.

X-ray

Intraoperative imaging

The steps of a PCNL are illustrated from retrograde access into the left kidney, to renal collecting puncture through to wire and sheath insertion with track dilatation and then nephroscope insertion to allow for nephrolithotomy.

CT

Post operative study

Post procedural nephrostomy tube insertion.

No residual renal or ureteric calculi.

Incidental small right inguinal hernia.

Case Discussion

Percutaneous nephrolithotomy (PCNL) is a surgical procedure for the extraction of large renal calculi. It is usually performed in the operating theater either by a urologist or combined urologist-radiologist team.

This case is to illustrate the typical imaging pathway of a percutaneous nephrolithotomy, including the images intra-operatively.

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Case information

rID: 48269
Published: 29th Sep 2016
Last edited: 7th Dec 2018
Inclusion in quiz mode: Included

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