lower urinary tract stone case presentation

2. 35 Year Male
Presented with Left
Lower Abdominal Pain
Presented by
Dr. Md. Tasnimul Khair Shovon
MS- Student (Part- 3)
Department of Urology
Sir Salimullah Medical College and Mitford hospital

3. Salient feature
Mr. shabuddin, 35 yrs old, male, muslim,
married, van driver from postogola, Dhaka
presented to me with the complaints left
lower abdominal pain for 6 months which
was colicky in nature, moderate in severity,
radiate to groin and scrotum,

4. No aggravating factor but relieved by taking
rest and some medication which was
prescribed by local doctor. There was 3
times attack of pain. It has no relation with
food but sometimes associated with mild
fever and vomiting.

5. There was no history of fever with chill and
rigor. There is no history of hematuria,
calciuria or any fleshy material pass through
urine. Patient has no history of increased
frequency of micturition, urgency, dysuria
or evening rise of temperature.

6. He has no history of per-urethral
catheterization or instrumentation. There is
no history of anorexia, weight loss, cough,
chest pain, haemoptysis, hematomesis,
jaundice, melena or bone pain. There is no
history of blood transfusion. Patient bowel
habit is normal.

7. Patient is smoker and maintains lower
socioeconomic condition.
On general examination all parameter are
within normal limit.

8. On genitourinary system examination
Kidney and urinary bladder are not
palpable, renal angels are not tender, hernia
orifice are intact and left inguinal region are
not tender.

9. EUM, penis, palpable part of urethra,
scrotum, testes, epididymis and perineum
are normal. On digital rectal examination
nothing abnormality detected. Other system
revels no abnormality.

10. Provisional Diagnosis
 Urinary tract infection.

11. Differential diagnosis
 Left ureteric stone
 Urinary bladder stone

12. Investigation
 Urine routine
and microscopic
examination
Pus cell- 5-
6/HPF
RBC- Nil
Urine Culture and
antibiotic
sensitivity- No
growth.

13. Complete blood count
 HB- 13.8 gm/dL
 TC- 10750/cmm
 Neutrophil – 50%

14. Ultrasonography of
whole abdomen
Left ureteric stone size
8 mm

15. Plain X ray KUB

16. Intravenous urography (IVU)

18. Other investigation

19. Confirmatory diagnosis
 Left lower ureteric stone.

20. Treatment
 Ureteroscopy with
intracorporeal
pneumatic lithotripsy