PMC5937608_01
Contrast enhanced CT scan of renal tract, in coronal plane showing appearance of matrix stone throughout the right kidney.
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There was no opacification of the right ureter and although there was function in the right kidney there was extreme cortical thinning over the calyces (Figure 1).
Retrograde pyelogram of right kidney with filling defects throughout. The arrow points to the site of the surgery which is the right kidney.
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Flexible ureterorenoscopy confirmed large volume of stone throughout the entire collecting system (see Supplementary Video (available here) and Figure 2).
Macroscopic appearance of stone following PCNL. One small square equals 1 mm x 1 mm.
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The widespread extent of stone made ureteroscopic laser lithotripsy unsuitable and so the patient was managed with percutaneous nephrolithotomy (PCNL) (Figure 3).