|IMAGES IN CLINICAL PRACTICE
|Year : 2017 | Volume
| Issue : 1 | Page : 49
Encrusted Calculi Over a Forgotten Double J Ureteral Stent
Sanjay Dhawan, Pankaj Garg, Pawanindra Lal, Anubhav Vindal
Department of Surgery, Maulana Azad Medical College, New Delhi, India
|Date of Web Publication||1-Mar-2017|
Room 512, Old Resident Doctor’s Hostel, Lok Nayak Hospital, MAMC Campus, New Delhi 110002, Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Dhawan S, Garg P, Lal P, Vindal A. Encrusted Calculi Over a Forgotten Double J Ureteral Stent. MAMC J Med Sci 2017;3:49
A 30-year-old female patient presented with pain in the lower abdomen and left flank, which was associated with fever and burning micturition. She underwent vesico-vaginal fistula repair with bilateral double J ureteral stenting 5 years ago. Right double J ureteral stent (DJS) was removed in the follow-up period. The patient did not follow-up thereafter, and presented now with old, fragmented left side DJS in situ with two vesical calculi encrusted over the fragmented stent and a calcified fragment in the left renal pelvis [Figure 1]. The patient underwent open cystolithotomy [Figure 2] and was planned for left pyelolithotomy for encrusted stone over broken DJS in the left renal pelvis. The patient was again lost to our follow-up despite being advised an open pyelolithotomy procedure for the renal calculi.
|Figure 1: X-ray kidney, ureter and bladder (KUB) showing two vesical calculi formed over broken fragments of double J stent in urinary bladder and left calcified double J fragment in left renal pelvis|
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The patient and the patient’s relatives should be informed about the need, complications and timely removal of DJS. The use of the DJS should be documented (name, address and contact information). Kelkar and Patil managed a similar patient with a forgotten DJS and severe multiple large encrusted stones in the bladder and the renal pelvis, and with cystoscopic removal of bladder stone and right pyelolithotomy and ureterolithotomy. Learning point is that such patients who are prone to non compliance should be operated in the same hospital admission sitting, because they pose a similar risk of losing to follow-up repeatedly and, thereby, complicate their well-being further.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Kelkar V, Patil D. Management of forgotten double J stent and severe multiple large encrusted stones in the bladder and renal pelvis. Cent Eur J Urol 2012;65:239-41.
[Figure 1], [Figure 2]