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Case presentation

Case presentation. Omar alhunaidi Farwaniya Hosp. history. 33 year old Sudanese male, presented with: lt loin pain fever CBC: leukocytosis RFT: N Urine R/M: blood ++ leuk +++ Urine C/S: sent. KUB: lt staghorn. CT KUB. Emergency lt DJS was fixed.

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Case presentation

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  1. Case presentation Omar alhunaidi FarwaniyaHosp.

  2. history 33 year old Sudanese male, presented with: ltloin pain fever CBC: leukocytosis RFT: N Urine R/M: blood ++ leuk +++ Urine C/S: sent

  3. KUB: lt staghorn

  4. CT KUB

  5. Emergency lt DJS was fixed

  6. Isotope Scanning MAG 3 LEFT 39% Right 61% Urine c/s was positive  E. coli Fever subsided after few days of IV Abx ( Tazo) Discharged on oral Abx ( cipro for 2 wks)

  7. Appointed for elective PCNL Vs. Open after 2 months Pt chose open approach Given Abx for 2 weeks prior to surgery “ Cipro”

  8. Dissection revealed total intra-renal pelvis Lt anatrophicnephrolithotomy Cold ischemia time: 40 minutes Total operative time: 3 hours Blood loss <100 ml

  9. follow up KUB: stone free follow up renogram 76 % Rt kidneyand 24% left

  10. After 1 year, f/u KUB and Renogram were done • KUB  no ROS • Renogram with split renal function was • Rt 63% • Lt 37%

  11. The AUA Panel identified four modalities as potential alternatives, on the strength of the evidence, for treating patients with staghorn calculi: • Percutaneous nephrolithotomy (PNL) monotherapy • Combinations of PNL and shock-wave lithotripsy (SWL) • SWL monotherapy; and • Open surgery – open surgical exposure of the kidney and removal of stones from the collecting system, typically anatrophic nephrolithotomy

  12. STONE-FREE RATE • PCNL 78% (74-83%) • Combination 66% (60-72%) • ESWL Monotherapy 54% (45-64%) • Open Surgery 71% (56-84%)

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