Bilateral ureteric stones: an unusual cause of acute kidney injury

Abstract

A 49-year-old man presented to the accident and emergency department, with a short history of vague abdominal pain, abdominal distension and two episodes of frank haematuria. A plain chest film showed dilated loops of large bowel and blood results on admission showed an acute kidney injury (stage 3). A diagnosis of bowel obstruction was made initially but a CT scan of the abdomen showed bilateral obstructing calculi. After initial resuscitation, the patient had bilateral ultrasound-guided nephrostomies and haemofiltration. He later underwent bilateral antegrade ureteric stenting. A decision will later be made on whether or not he is fit enough to undergo ureteroscopy and laser stone fragmentation.

Figure 1

A coronal CT scan of the patient showing bilateral ureteric calculi obstructing the vesicoureteric junctions bilaterally.

Figure 2

A coronal CT scan image showing urostomies and ureteric stents in place.