Opinion on a stone please

Dear friends, this IVU is uploaded for the benefit of PGs.

Kindly take a look and share your thoughts. Seniors may please assist giving your inputs please.
Chandra Singh

Opinion on a stone pleaseOpinion on a stone pleaseOpinion on a stone please


    09 Feb 2021 08:02:12 PM

    Hello sir, 

    This IVU shows a right sided upper calyceal impacted calculus with a wide infundibulum. Rirs could be the first option, if unavailable, mini pcnl can be attempted. Pcnl is second option just coz it will need a supra 12th rib puncture in this case. Last film although gives an impression of upper calyceal diverticular calculus, it can be confirmed with on table RGP. 

  • Pankaj N Maheshwari
    Pankaj N Maheshwari
    09 Feb 2021 09:59:14 PM

    I agree with Amit.

    This IVU would need a proper oblique image to really confirm the position of the calculus. Could be in an impacted calyx or in a diverticulum.
    Even i would plan RIRS / mini-Perc

  • aditya gupta
    aditya gupta
    11 Feb 2021 11:12:32 PM

    Appears to be a calyceal diverticula stone..CT urography. Would prefer rirs as upper calyx . Blue Spritz technique or Usg guided puncture and methylene blue instillation  if atretic orifice not visualised by Rirs.

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