Giant staghorn stone causing inferior vena cava compression: a novel case report.

Autor:	Alghafees MA; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences., Abdul Rab S; College of Medicine, Alfaisal University., Raheel HM; College of Medicine, Alfaisal University., Sabbah BN; College of Medicine, Alfaisal University., Maklad AE; College of Medicine, Alfaisal University., El Sarrag MI; College of Medicine, Alfaisal University., Abouelkhair AE; College of Medicine, Alfaisal University., Aljurayyad A; Department of Urology, King Saud University Medical City., Alotaibi T; Department of Urology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Alotaibi MT; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences., Alomar M; Department of Urology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2023 May 03; Vol. 85 (6), pp. 2990-2994. Date of Electronic Publication: 2023 May 03 (Print Publication: 2023).
DOI:	10.1097/MS9.0000000000000680
Abstrakt:	Staghorn calculi (SC) are defined as large kidney stones that fill the renal pelvis and at least one renal calyx. They represent 10-20% of all renal stones in developing countries and require prompt diagnosis and management. Massive SC (over 5 cm) are treated exclusively via open surgery, despite percutaneous nephrolithotomy (PCNL) being the gold standard treatment for large stones. Descriptions of PCNL for massive SC are very limited in the literature. Case Presentation: We report a case of a 63-year-old male who presented with chronic abdominal pain, hepatosplenomegaly, and normal renal function. He was later diagnosed with polycythemia vera. Computed tomography of the abdomen revealed massive, bilateral staghorn stones measuring 7.3×5.5 cm and 1.8×4.5 cm on the right and left, respectively. Additionally, the right stone was found to be compressing the inferior vena cava (IVC). The patient was promptly scheduled for right-sided PCNL and the target of 80% stone fragmentation was successfully attained. Discussion: We present the first case of a stone of such size in the Middle East, as well as the first known case of a renal stone compressing the IVC. Unlike previous reports, the stone was successfully fragmented via PCNL - a procedure that has not been described for stones of such size. Conclusion: This report highlights that ultrasound-guided PNCL without any other intervention is sufficient for the successful treatment of giant SC. Greater research is needed on the potential utility of using ultrasound-guided PCNL for the fragmentation of stones sized over 5 cm. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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