Miniaturized Tract Percutaneous Nephrolithotomy for Pelvic Stone Management in a Two-Year-Old: A Case Report and Review of Literature.

Renal lithiasis in pediatric patients, although rare, affects children of all ages and both genders. Endourology has recently emerged as a safe and effective method for treating stones in children, thanks to advances in equipment and growing experience with retrograde and percutaneous treatments in adults. However, performing percutaneous nephrolithotomy (PCNL) in this age group presents unique challenges due to the smaller anatomical dimensions. We describe the case of a two-year-old girl with a history of multiple febrile urinary tract infections. A computed tomography (CT) scan shows a stone in the pelvis of the left kidney, measuring 7.43 x 5.64 x 10 mm with a density of 450 HU and no evidence of hydronephrosis. The patient was treated with a single session of miniaturized percutaneous nephrolithotomy (mini-PCNL). Mini-PCNL presents a safe and effective option for treating kidney stones in pediatric patients. This approach demonstrates a high stone-free rate and low complication incidence, making it a viable alternative for young patients requiring stone removal.