Salvage of an obstructed single kidney by combined percutaneous nephrostomy, percutaneous stone extraction and alkalinisation.

A 72-year-old woman with a single kidney and renal calculi was admitted as an emergency with sepsis and anuria. Renal drainage was established by percutaneous nephrostomy (PTN) as an emergency procedure. A nephrostogram showed multiple lucent stones and a single opaque calculus in the renal pelvis. The definitive treatment of the mixed calculi was carried out through the PTN. The lucent stones were dissolved by alkaline irrigation and the opaque stone removed by a biliary basket via the dilated tract. The safety and simplicity of PTN as an emergency procedure and its use for definitive treatment with the avoidance of surgery are stressed.