Monday, April 1, 2013

CLEARANCE OF COMPLETE STAGHORN CALCULUS IN A SMALL CHILD WITH PCNL IN RAMAYYA PRAMILA HOSPITAL


A 5 year old boy presented with recurrent pain in left kidney and fever.On a complete evaluation he was found to have a complete staghorn calculus in the left kidney.

His IVP showed a normally excreting kidneys on both sides and his biochemical and hematological work up was essentially normal.

He was taken up for PCNL with due preoperative antibiotic course.

We did mid-posterior calyceal puncture and the tract was dilated till 24 Fr.The 24 Fr Amplatz sheath was inserted and with pneumatic lithotripsy ; the calculus was fragmented and removed.The calculus was matrix in nature with outer brittle shell. The matrix tissue was teased and removed with the forceps.The upper and lower calyceal fragments were removed with flexible nephroscopy and forceps.
POSITION FOR RGP

LEFT RADIOLUCENT STAGHORN CALCULUS

POSITION FOR PCNL

TRACT DILATED TILL 24 FR AND REGULAR PCNL DONE WITH PNEUMATIC LITHOTRIPSY



STONE APPEARANCE ON NEPHROSCOPY

USE OF FLEXIBLE CYSTOSCOPY FOR UPPER AND LOWER CALYCEAL FRAGMENTS

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1 comment:

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