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一名健康老年患者的巨大膀胱结石合并遗忘双J(DJ)支架复杂病例:病例报告

Complicated Case of a Giant Bladder Stone and Forgotten Double-J (DJ) Stent in an Otherwise Healthy Elderly Patient: A Case Report.

作者信息

Khushaym Abdulaziz H, Khan Adeel A, Aljeeran Noora O, AlAlhareth Ibrahim M, Rafie Mohamed A

机构信息

Medical School, Arabian Gulf University, Manama, BHR.

Urology, King Hamad University Hospital, Manama, BHR.

出版信息

Cureus. 2024 May 17;16(5):e60498. doi: 10.7759/cureus.60498. eCollection 2024 May.

Abstract

Giant bladder stones, defined as stones weighing over 100 g and/or measuring more than 4 cm in diameter, are relatively uncommon compared to other types of urinary tract stones. This patient, an 85-year-old male with an unknown medical history, initially presented with urinary incontinence and hematuria. Radiological findings revealed a large prostate, a forgotten left renal double-J (DJ) stent for more than 20 years with an encrusted bladder stone, and additional calculi in the lower pole of the left kidney. The patient underwent laser cystolithotripsy, but due to the complexity of the case, a second procedure was scheduled. Following the second procedure, the patient experienced a generalized tonic-clonic seizure and subsequent loss of consciousness, which was attributed to hyponatremia. The patient received appropriate management to correct hyponatremia and antiepileptic medication to control the seizure. The patient's condition eventually improved and he was discharged home with prescribed medications and follow-up appointments. This case emphasizes the potential complications of giant bladder stones and a forgotten DJ stent in an 85-year-old male patient as a rare consequence following such a rare presentation.

摘要

巨大膀胱结石定义为重量超过100克和/或直径超过4厘米的结石,与其他类型的尿路结石相比相对少见。该患者为一名85岁男性,病史不明,最初表现为尿失禁和血尿。影像学检查发现前列腺肿大、一枚遗忘在体内超过20年的左肾双J(DJ)支架并伴有膀胱结石形成,以及左肾下极有额外结石。患者接受了激光膀胱碎石术,但由于病例复杂,安排了第二次手术。第二次手术后,患者出现全身强直阵挛性发作并随后失去意识,这归因于低钠血症。患者接受了纠正低钠血症的适当治疗以及控制癫痫发作的抗癫痫药物治疗。患者病情最终好转,带着处方药和随访预约出院回家。该病例强调了在一名85岁男性患者中巨大膀胱结石和遗忘的DJ支架的潜在并发症,这是如此罕见表现后的罕见后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e75/11180448/593e0424ceaa/cureus-0016-00000060498-i01.jpg

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