Nature clinical practice. Urology · 2008
A case of staghorn stones in a kidney with an ileal ureter treated by percutaneous nephrolithotomy.
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Gao Xiaofeng, Zhou Tie, Li Jinyi, Sun Yinghao
Аннотация
BACKGROUND: A 59-year-old man was admitted to hospital for investigation of a 1-year history of intermittent hematuria. He had undergone ileal ureteral replacement for left renal stones 36 years earlier.
INVESTIGATIONS: Renal ultrasonography, physical examination, abdominal plain radiography, intravenous urography, CT urography, measurement of serum levels of creatinine, urea and electrolytes, renal scintigraphy, urinalysis and urine culture.
DIAGNOSIS: Staghorn calculi in the left kidney, with a high-lying anastomosis between the renal pelvis and the proximal ileal segment.
MANAGEMENT: The patient underwent percutaneous nephrolithotomy via a middle-calyx access for the large staghorn stones. After surgery, no residual calculi were found and the patient was discharged with an uneventful postoperative course. At 1 month, renal scintigraphy showed normal bilateral kidney function. The patient received potassium citrate supplementation and was followed up with 6-monthly imaging studies. At the last report, he had been stone-free for 7 months.
INVESTIGATIONS: Renal ultrasonography, physical examination, abdominal plain radiography, intravenous urography, CT urography, measurement of serum levels of creatinine, urea and electrolytes, renal scintigraphy, urinalysis and urine culture.
DIAGNOSIS: Staghorn calculi in the left kidney, with a high-lying anastomosis between the renal pelvis and the proximal ileal segment.
MANAGEMENT: The patient underwent percutaneous nephrolithotomy via a middle-calyx access for the large staghorn stones. After surgery, no residual calculi were found and the patient was discharged with an uneventful postoperative course. At 1 month, renal scintigraphy showed normal bilateral kidney function. The patient received potassium citrate supplementation and was followed up with 6-monthly imaging studies. At the last report, he had been stone-free for 7 months.