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
Modality: CT

Proximal left ureteric stone with gross hydronephrosis.

Cortical thinning of the left kidney.

Modality: 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.

Modality: X-ray

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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