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Urinary tract full of stones
Urinary tract full of stones
Urinary tract full of stones
Urinary tract full of stones
Urinary tract full of stones
Urinary tract full of stones
Urinary tract full of stones
Urinary tract full of stones
Urinary tract full of stones
Urinary tract full of stones
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Urinary tract full of stones

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  • 1. Urinary tract full of stones Ranjit pandey ranjitpandey17@gmail.com Cist college,Ktm +977-9849464685
  • 2. Introduction  Mr. K S  31 years/male, driver  Kalanki  Chief complaint : pain in the left flank 1 wk back  DOA : 063/8/14
  • 3. HOPI  1 wk back sudden attack of pain in the left flank and back colicky and radiating downwards to the groin associated with one episode of vomiting  Went to TUTH and diagnosed as having renal stone  No h/o frequency, burning micturition haematuria and fever  Passing stool normally  Smoker, 10-12 sticks per day, drinks alcohol occasionally
  • 4. On examination  Average build, normal nutritional status  Afebrile,  PR : 96/min  BP : 110/90 mmHg  RR : 20/min  Pallor , icterus and edema absent  Chest : NAD, Heart : NAD  P/A : tender in left lumbar region on deep palpation
  • 5. Investigations  Hb 13.9 gm%  WBC 9700/cmm (N75%, L19%,E4%)  B+ve  RBS 85 mgm%  Urea 35 mgm%  Creatinine 1.3 mgm%  Calcium 10.6 mgm%  Phosphorus 4.1 mgm%
  • 6. Contd  Urine R/E WBC 2-3 RBC 12-15  Urine C/S : No growth  IVU : Bilateral multiple renal calculi left ureteric calculi at proximal part Right kidney normally excreting but left kidney delayed excreting
  • 7. mgmt  Operated on 063/8/15  Operation Left pyelolithotomy left ureterolithotomy left URSL and DJ stent  Post op findings left hydronephrotic kidney two large calculi in intra-renal pelvis multiple calculi in ureter at different level
  • 8. Procedure - left Morison's incision - pyelotomy made and stone removed - ureterotomy made and 4 stones retrieved - 2 impacted stones confirmed by URS - lithotripsy done from above for 1 calculus - DJ stent kept but could not proceed to bladder - URS performed from below and stone removed - DJ stent in bladder confirmed
  • 9. Contd  Put on I/V fluids tab paracetamol, tab ibuprofen inj gentamicin  Post op : uneventful  Discharged on 4th post op day  On F/U visit : doing well
  • 10. Thank you

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