 |
|
||||
|
|||||
| About | Latest Articles | Back-Issues | Articles
|
Search | Instructions | Online Submission | Subscribe | Etcetera | Contact |
| |||||||||||||||||||||
|
Silent giant ureteric calculus in a child (a case report).
The ureteral stones are usually small and about 50% of them are less than 5 mm in diameter.[3] Burkland[2] could find in the literature, reports of only 29 ureteric stones measuring more than 5 cm in length or diameter. We report a child with a large but silent ureteral calculus for its rarity and unusual presentation.
A 7 year old boy presented with poor general health, loss of weight and oedema of face of 6 months' duration. The child was ill nourished and anaemic. The abdomen was unremarkable. The urine had traces of albumin and a, few pus cells but was sterile on culture. The blood urea was 247 mg% and serum creatinine 6 mg%. The plain radiograph of the abdomen showed a dense calcified shadow in the left and a very small opacity in the line of the lower right ureter. The child was dialysed and an infusion pyelogram showed right sided hydronephrosis. There was a small radio-opaque shadow in the line of the lower ureter. The left kidney was poorly functioning and a large radio-opaque calculus was seen in the lower ureter. The metabolic workup was within normal limits. Bilateral ureterolithotomy was performed. The left ureter was exceedingly thickened and uniformly dilated. The size of the stone from the left ureter was 7 x 3 x 2.5 cm. A 6F catheter could not be negotiated through the left ureterovesical opening, which necessitated cystotomy and meatotomy of the orifice. The post-operative recovery was uneventful. An IVP done 3 weeks after the operation showed regression of hydronephrosis on the right side and improved function in the left kidney.
The concretions which exceed 5 cm in size were termed giant ureteric calculi[5] and are rare.[1] It is exceedingly rare to have these giant stones in the paediatric age. The largest calculus so, far reported was by Mayers[4] which measured 11 x 5.5 x 5 cm and weighed 286 gm, while the longest stone reported was by Taylor,[6] which was 21.5 cm in length. Gross derangement of renal function without any abdominal symptoms was the presenting feature in the present case. Partial obstruction at the vesicoureteral orifice was responsible for the giant calculus in this child, which required surgical correction at the time of calculus removal, to avoid recurrence.
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||
