Brix Jonnard G.

Vasallo

FORMATIVE CMC
STAGHORN CALCULI

Key Learning Points

Staghorn is a large branching stone that fill part of all of the renal pelvis and renal calyces. This is seen in
the KUB UTZ and CT sonogram and presented in our patient as hypogastric pain, flank pain, chills, and
fever.

Renal stones are formed usually due to certain diets of the patient (such as high salt or higher Vit C than
the physiologic dose (>2g), but is usually caused by low hydration state.

Treatment of renal stones includes

- Shockwave Lithotripsy (SWL) and

- Percutaneous Nephrolithotomy (PNL).
- Open Surgery

SWL is one of the noninvasive options of management of renal stones to which the stones are
subjected to Shockwave with a configured setting such that it will destroy the stones. However, bigger
stones like staghorn calculi cannot fully destroy these stones. Hence, PNL is the option for bigger stones.
PNL on the other hand is one of the invasive options to which the surgeon uses an small incision towards
the stone and inserts a wire and destroys the stone intraoperatively through laser. If this is not enough
or if the function of the kidney is too impaired, open surgery may prompted.

Urosepsis – infection from retained urine that spreads to the blood. Cause of the fever and chills.

Management of Urosepsis: - Culture based antibiotic therapy

Supportive Managements of Urolithiasis (better if after the treatment) and Urosepsis

- Paracetamol for Fever

- Ibuprofen for inflammation and pain
- Thiazide
- Hydration
- Low salt diet
- Physiologic dose of Vit C only