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LETTER TO EDITOR
Year : 2023 | Volume
: 34
| Issue : 4 | Page : 209-210
Complete staghorn stone of rotated duplicated-pelvicalyceal horseshoe kidney
Liang-Chen Huang, Chien-Hua Chen
Division of Urology, Department of Surgery, En Chu Kong Hospital, New Taipei City, Taiwan
Correspondence Address:
Chien-Hua Chen
Division of Urology, Department of Surgery, En Chu Kong Hospital, No. 399, Fuxing Road, Sanxia, New Taipei City 237
Taiwan
Source of Support: None, Conflict of Interest: None
DOI: 10.4103/UROS.UROS_84_22
Dear Editor,
A 60-year-old woman suffering from right flank pain and intermittently gross hematuria for 3 months presented to our clinic. The kidney, ureter, and bladder X-ray showed a 9.5 cm complete staghorn stone occupying her right rotated renal pelvicalyces [Figure 1]. To differentiate the relationship between her rotated pelvicalyces, intravenous pyelography was performed, which showed fulfilled right rotated duplicated renal with a patent ureter and bilateral inward-expanding renal calyces, which suggested horseshoe kidney [Figure 2]. Further computed tomography scan confirmed parenchymal isthmus horseshoe kidney with type II vessel anatomy, where ectopic arteries arose from the distal aorta in addition to the orthotopic renal arteries.[1] The present case is an inspirational scenario for nephrolithiasis management, which is a candidate for multitract percutaneous nephrolithotomy (PCNL), laparoscopic or robot-assisted laparoscopic pyelolithotomy, endoscopic combined intrarenal surgery with or without concurrent laparoscopic pyelolithotomy, or multistage surgery. The pros and cons of every procedure were thoroughly explained to and understood by the patient and her family. After the patient-centered shared decision-making, the patient underwent one PCNL followed by one retrograde intrarenal surgery 3 weeks later, and extracorporeal shock wave lithotripsy for a tiny residual stone at the right lower renal calyx at 1-month follow-up.
Figure 1: This KUB X-ray showed a 9.5 cm complete staghorn stone at the right rotated renal pelvicalyces. KUB: Kidney, ureter, and bladder
Figure 2: This 15-min delayed intravenous pyelography revealed a right rotated duplicated renal pelvicalyces occupied by a complete staghorn stone with a patent ureter and bilateral inward-expanding renal calyces, which suggested horseshoe kidneyDeclaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
Data Availability Statement
All data generated or analyzed during this study are included in this published article.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
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