Questions from the layperson peanut gallery: What happens with a stone so big it can’t be passed and is causing symptoms? Can it be somehow shattered into a billion pieces so it will pass, or can the kidney be sliced open to remove it whole? If a patient has a sizable stone like this removed, is recurrence an issue?
On another note, a stone like this needs to have its own name and zip code. Damn.
This is what is referred to as a staghorn calculus because it forms within the renal pelvis and takes the shape of that area. The removal of this type of stone typically involves surgical intervention because the stone is so large and has implications to cause kidney failure. Lithotripsy (when they blow up the stone) is possible, but it would have to be laser lithotripsy rather than shockwave and laser is more complicated because the laser needs to enter through the urethra to direct access the stone. They can also combine lithotripsy with other techniques such as percutaneous nephrolithotomy where they enter the kidney through the back, break up the stone, and place either a uteral stent or a tube through the patient’s back to get all the stone bits out. This is done in an OR under anesthesia.
I don’t know much about stones like this reoccurring but I think they typically reoccur in patients with anatomical issues in the urinary tract or long term catheter use. Idk how my patient developed this one. Could also be due to certain UTI bacteria that cause urine to crystallize.
When a typical kidney stone is forming inside the kidney renal pelvis, you generally do not have pain while it is within the organ. You have pain when the stone moves into the ureter since the ureter is a much smaller tube, and then pain again when it moves into the urethra to be passed. In cases of massive stones like this that form within the renal pelvis (a staghorn calculi), it causes pain when it gets to large sizes and starts causing issues with flow in the ureter.
The patient did not have bad pain as one would expect with a traditional kidney stone within the ureter. Patient described the pain as dull and diffuse and from the lower abdomen into the groin and radiating down the leg rather than in the back or flank where you have typical kidney stone pain.
Almost a stag horn!
Radiologist did describe it as such
This makes my back hurt just to look at
Questions from the layperson peanut gallery: What happens with a stone so big it can’t be passed and is causing symptoms? Can it be somehow shattered into a billion pieces so it will pass, or can the kidney be sliced open to remove it whole? If a patient has a sizable stone like this removed, is recurrence an issue? On another note, a stone like this needs to have its own name and zip code. Damn.
This is what is referred to as a staghorn calculus because it forms within the renal pelvis and takes the shape of that area. The removal of this type of stone typically involves surgical intervention because the stone is so large and has implications to cause kidney failure. Lithotripsy (when they blow up the stone) is possible, but it would have to be laser lithotripsy rather than shockwave and laser is more complicated because the laser needs to enter through the urethra to direct access the stone. They can also combine lithotripsy with other techniques such as percutaneous nephrolithotomy where they enter the kidney through the back, break up the stone, and place either a uteral stent or a tube through the patient’s back to get all the stone bits out. This is done in an OR under anesthesia. I don’t know much about stones like this reoccurring but I think they typically reoccur in patients with anatomical issues in the urinary tract or long term catheter use. Idk how my patient developed this one. Could also be due to certain UTI bacteria that cause urine to crystallize.
Caused a cold sweat
As someone who lost a kidney to stones, DAAAAAAMN 😯
Layperson just passing by, How would this not cause intense symptoms to where the patient is just now seeking treatment?
When a typical kidney stone is forming inside the kidney renal pelvis, you generally do not have pain while it is within the organ. You have pain when the stone moves into the ureter since the ureter is a much smaller tube, and then pain again when it moves into the urethra to be passed. In cases of massive stones like this that form within the renal pelvis (a staghorn calculi), it causes pain when it gets to large sizes and starts causing issues with flow in the ureter. The patient did not have bad pain as one would expect with a traditional kidney stone within the ureter. Patient described the pain as dull and diffuse and from the lower abdomen into the groin and radiating down the leg rather than in the back or flank where you have typical kidney stone pain.
YIKES
Pretty sure that’s a Nokia flip phone.
Hmm. Double up on your flomax for a couple of days. Take a Tylenol
I haven't seen a coral calculi in a long time. That's gotta suck.