12 years old girl presented with vague complaints of pain in abdomen. X-ray KUB and usg reports are attached. Please suggest the treatment in centers where endoscopic treatment is not available.

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USG report says Kidney no stones no hydronephrosis and impressions say renal stones with hydronephrosis and the X-ray showed staghorn calculus. Such report can put a doctor in danger!

Rt stag horn calculus no hydronephrosis three ways urethroscopicaly with shunt pcnl lithotripsy all good ideal pcnl

Right partial staghorn calculus... Needs PCNL..open nephrolithotomy if endoscopy not available..complete clearance is important and send stone for analysis ..look for metabolic causes or infective pathology

Staghorn in Rt.in pelvicalvyceal system Hydrometer onerous.

Stag horn calculus Rt. Kidney. Nephrolithotomy

The next step should be IVP to know the function of kidneys.

Do Urine RAnd M Culture, Stool, CBC,LFT. Stone seems to be silent Other etiology should be kept in mind,

Staghorn calculus Rt kidney.

Calculus in rt side with hydronephrosis

If RFT are normal. Do DMSA scan and decide accordingly. You may shift the patient to higher centres. Our plan has to save the kidney.

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