PMC5515093_01
(a) KUB showing two radio-opaque shadows representing the two stones in the left renal region. (b) Intravenous urography showing the location of the stones in the collecting system and the configuration of the pelvicaliceal system. KUB, kidney, ureter, and bladder radiograph.
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Urinary tract plain and intravenous urography showed left renal pelvic and lower calix stones 2.5 cm in maximum length without hydronephrosis (Fig. 1a, b).
Erect abdominal plain film showing the multiple air-fluid levels and air under diaphragm.
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The patient was planned for antegrade nephrostogram study and contrast CT scan study of the abdomen, but after surgical consultation, the decision was for urgent laparotomy when erect plain abdomen X-ray showed multiple air-fluid levels and air under diaphragm (Fig. 2).
The jejunal perforation: close view of the perforation showing the size of the injury related to the jejunal circumference.
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After its mobilization, it was found to be partially injured with perforation of about 1/4th of the circumference (Fig. 3).