TITBITS IN URORADIOLOGY

1. Pancreatic calcification MASQERADING as kidney stone. 

This is as plain X-ray KUB of 44 years gentleman presenting with right flank pain. On evaluation there was a right upper ureteric calculus with Hydroureteronephrosis  and a left lower calyceal calculus . Right URS Laser Litho + JJ stenting was done . This is post operative KUB showing radio-opaque density in the right renal fossa. He is known case of chronic calcific pancreatitis.   

Pancreatic calculus

TITBITS IN URORADIOLOGY

1. PANCREATIC CALCIFICATION MASQUERADING AS KIDNEY STONE

Nephrectomy for pyonephrotic kidney

A 60 year old lady came with on and off fever and left  iliac fossa pain.On evaluation she was found to have ectopic enlarged kidney with pyonephrosis.She was a known case of atrial septal defect with early changes of Pulmonary Arterial Hypertension.She was taken up for open nephrectomy with Extended Gibsons incision.Subcapsular nephrectomy was performed for the planes around the kidney were obscured because of adhesions.The patient recovered well after the surgery and was discharged on 4 th post operative day.

The specimen of the kidney is shown below..

Real time imaging of ESWL

This is a real time image of ESWL showing fragmentation of a kidney stone into fine powder.

This procedure is being performed on the state of the art Dornier Compact Delta ESWL machine. The ESWL if scrupulously done can avoid PCNL and subsequent RIRS in significant number of cases.

The most important thing for ESWL success is choosing right case (Naveen et al. WCE 2004 .Predicting factors for ESWL), continuous real time image monitoring by trained professional, under anaesthesia cover (compromised intensity for pain can have compromised outcome too...).

Large Staghorn kidney stone in a patient with myelodysplastic syndrome removed by PCNL through a SINGLE TRACK

            A 60 year gentleman, suffering from myelodysplatic syndrome presented with left flank pain. On evaluation there was a complete staghorn calculus in the left kidney. He had a history of left open pyelolithotomy 20 years ago. His coagulation profile was normal. PCNL was done through superior calyceal puncture, and complete stone clearance was achieved. Postoperative recovery was uneventful.

Pre Operative KUB

Post Operative KUB