Urinary tract full of stones
Ranjit pandey
ranjitpandey17@gmail.com
Cist college,Ktm
+977-9849464685
Introduction
 Mr. K S
 31 years/male, driver
 Kalanki
 Chief complaint : pain in the left flank
1 wk back
 DOA : 063/...
HOPI
 1 wk back
sudden attack of pain in the left flank and back
colicky and radiating downwards to the groin
associated ...
On examination
 Average build, normal nutritional status
 Afebrile,
 PR : 96/min
 BP : 110/90 mmHg
 RR : 20/min
 Pal...
Investigations
 Hb 13.9 gm%
 WBC 9700/cmm (N75%, L19%,E4%)
 B+ve
 RBS 85 mgm%
 Urea 35 mgm%
 Creatinine 1.3 mgm%
 C...
Contd
 Urine R/E
WBC 2-3
RBC 12-15
 Urine C/S : No growth
 IVU : Bilateral multiple renal calculi
left ureteric calculi...
mgmt
 Operated on 063/8/15
 Operation
Left pyelolithotomy
left ureterolithotomy
left URSL and
DJ stent
 Post op finding...
Procedure
- left Morison's incision
- pyelotomy made and stone removed
- ureterotomy made and 4 stones retrieved
- 2 impac...
Contd
 Put on I/V fluids
tab paracetamol, tab ibuprofen
inj gentamicin
 Post op : uneventful
 Discharged on 4th post op...
Thank you
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Urinary tract full of stones

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Transcript of "Urinary tract full of stones"

  1. 1. Urinary tract full of stones Ranjit pandey ranjitpandey17@gmail.com Cist college,Ktm +977-9849464685
  2. 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. 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. 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. 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. 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. 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. 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. 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. 10. Thank you

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