Pyonephrosis Drainage Failure with Two Ureteric Stents in a Paediatric Patient

• Main Authors: Gautamram Choudhary, Pritesh Jain, Prateek Gupta, Likhiteswar Pallagani
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2020-02-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: nephrolithotomy; percutaneous nephrostomy; pyonephrosis; urinary diversion
• Online Access: https://www.jcdr.net/articles/PDF/13532/43129_F(SHU)_CE[Ra1]_(SL)_PF1(AJ_KM)_PN(SL).pdf

For obstructed uropathy causing pyonephrosis, immediate decompression by urinary diversion is the temporary mode of treatment. The type of procedure should be individualised depending on the size and position of stone, the degree of obstruction and the definite treatment planned for the obstruction in the near future. Percutaneous Nephrostomy (PCN) and retrograde Double J (DJ) stenting are the most widely used methods. According to currently available literature, there is no significant difference between these procedures with regards to availability, technical success, percentage of complications and the effect on quality of life of patients. Here, the authors present a case of a six-year-old male where internal drainage with two DJ stents did not drain the pyonephrosis. He had a right flank pain and fever on evaluation; was found to have right renal pelvic calculus with pyonephrosis. Even after putting two double J stent of size 3.6 French (Fr) the pyonephrosis could not be drained, eventually, right PCN of 6 Fr was placed, symptoms relieved and later on stone cleared with percutaneous nephrolithotomy.