Ureteric stone and subsequent management

Case contributed by Dr Ian Bickle

Presentation

40 year-old with severe left flank pain and fever.

Patient Data

Age: 40
Gender: Male

Proximal left ureteric stone with gross hydronephrosis.

Cortical thinning of the left kidney.

Fluoroscopy

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.

Related articles

- urolithiasis

- pyonephrosis

- percutaneous nephrostomy

- ureteric stent

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Case information

rID: 23323
Case created: 6th Jun 2013
Last edited: 25th Feb 2016
Inclusion in quiz mode: Included

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