HYDRONEPHROSIS SINISTRA ET CAUSA PARTIAL

STAGHORN CALCULI OBSTRUCTION SINISTRA

Devyana E.Taslim 1, Marta Hendry 2
1
Clinical Senior Cleckship, School of Medicine, Medical Faculty of Sriwijaya University, Dr.Mohammad Hoesin General
Hospital, Palembang
2
Department of Urology, School of Medicine, Medical Faculty of Sriwijaya University, Dr.Mohammad Hoesin General
Hospital, Palembang

Background
Hydronephrosis is a condition that typically occurs when one kidney becomes swollen due to the failure of
normal drainage of urine from the kidney to the bladder. This swelling most commonly affects only one kidney,
but both can be involved. Hydronephrosis is not a disease but a structural condition. It is a result of a blockage
of or obstruction in the urinary tract. While this condition occurs in about 1 in 100 adults, its also fairly
common in babies.
Clinical Presentation
A male patient 36 years old came to the surgery polyclinic of Muhammad Hoesin General Hospital with the
chief complain sore at the left waist. Since 1 and half month ago patient complain pain at the left waist. Then he
went to the specialist at Muara Enim hospital, and then he referred to hospital at Palembang. He went to AK
Gani hospital but the hospital does not have a complete equipment to do the surgery, then he referred to
Mohammad Hoesin Hospital. From the anamnesis pain became worsened, especially after sat for long time and
after lifted something heavy, fever (-), renal colic (+), pain at the rear side (+), joint pain at legs (-), sore feet (-),
numbness at legs (-), urinary dripping (-), continuous urinary (-), urgency urinary (-), normal urine color but the
frequencies and the quantity were lower than normal, normal stool, edema (-). From the physical examination
abdomen was within normal limit, there was tenderness at CVA region at the left area and enlarged kidney
palpable. Laboratory finding are increase in erithrosit (8.14), increase calcium (113), and creatinine (1.32). From
plain BNO examination of this patient, the result shows the radio opaque at the pelvic renalis (staghorn calculi)
at the upper left abdomen and the right abdomen, but the left one is more bigger than the right one, from IVP
test, from the contrast ultravist there is no allergic reaction, from the nephrogam the secresion and excresion
from both kidney are normal, pelvicocalics system (PCS) right is normal and left is extacis grade II, both left
and right ureter are normal, bully-bully size and shapes are normal, post miksi residu urine little. Result suspect
hydronephrosis grade II at the left kidney due to staghorn stone obstruction.
Conclusion
This case has reported a male patient 36 years old with the chief complain sore at the left waist. The complains
are the manifestation of the nephrolithiasis that can cause hydronephrosis. From the physical examination CVA
pain (+) and ballottement (+). It is confirm with BNO IVP examination. The diagnosis is hydronephrosis sinistra
et causa partial staghorn calculi obstruction sinistra. The main treatment for this patient is nephrolitotomy.
Keywords: sore hip, hydronephrosis, staghorn