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CORRESPONDENCE
Year : 2002  |  Volume : 18  |  Issue : 2  |  Page : 197-198
 

Stent block following extra corporeal shock wave lithotripsy of a renal calculus


Department of Uro-Nephrology, Sri Sathya Sai Institute of Higher Medical Sciences, Prashantigram, Anantapur District, Andhra Pradesh - 515 134, India

Correspondence Address:
A R Jayadev
Department of Uro-Nephrology, Sri Sathya Sai Institute of Higher Medical Sciences, Prashantigram, Anantapur District, Andhra Pradesh - 515 134
India
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Source of Support: None, Conflict of Interest: None


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Keywords: Stent; Block; ESWL; Renal; Calculus


How to cite this article:
Jayadev A R, Panchakshari C, Bhat P, Prasad N G, Sivakumar V. Stent block following extra corporeal shock wave lithotripsy of a renal calculus. Indian J Urol 2002;18:197-8

How to cite this URL:
Jayadev A R, Panchakshari C, Bhat P, Prasad N G, Sivakumar V. Stent block following extra corporeal shock wave lithotripsy of a renal calculus. Indian J Urol [serial online] 2002 [cited 2019 Sep 20];18:197-8. Available from: http://www.indianjurol.com/text.asp?2002/18/2/197/37648


Acute ureteric obstruction following Extra Corporeal Shock Wave Lithotripsy (ESWL) is a well-known com­plication. This is due to the obstruction caused by the small fragments of the broken stone - known as STEIN­STRASSE (street of stone). [1] However, the similar phe­nomenon occurring following ESWL in a patient with a ureteric stent in situ is unusual. We are reporting an epi­sode of stent block resulting in acute ureteric obstruction, anuria and uremia following ESWL.

A 22-year-old patient of right renal dysplasia with poor functioning left kidney due to pelviureteric junction ob­struction due to a calculus with renal failure (S.creatinine 12 mg%) was taken up for double J stenting of the left side to relieve the obstruction, following which the renal function and urinary output improved (S.creatinine I mg%). Four weeks later he was taken up for ESWL while the stent was in situ. He was observed for a day following ESWL. The hospital stay was uneventful and he was dis­charged with good urinary out put, no pain, haematuria or residual calculus, normal serum creatinine value with DJ stent in situ. One day later patient presented with left loin pain, anuria, vomiting with raised serum creatinine (5.9 mg%). Ultrasound study of renal system showed left hy­dronephrosis with DJ stent in situ. Immediately patient was taken up for review and if needed stent replacement keeping the possibility of stent obstruction. As expected the stent was found to be blocked with stone fragments and replacement with a new stent was resulted in good diuresis and reduction in pain, vomitings and azotemia. Patient was discharged subsequently and is on regular followup, maintaining normal serum creatinine value. This problem is highlighted to emphasize that obstruction can occur following ESWL even when the DJ stent is in situ and immediate review to exclude DJ stent obstruction will give gratifying result.

 
   References Top

1.Martin TV, Sosa RE. Shock wave lithotripsy. In : Walsh PC, Retik AB, Vaughan ED, Wein AJ, eds. Campbell's Urology, 7°i edn. Phila­delphia, Saunders. 1998; 2735-2752.  Back to cited text no. 1    




 

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