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 ::  Introduction
 ::  Case report
 ::  Discussion
 ::  References

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Year : 1984  |  Volume : 30  |  Issue : 1  |  Page : 60-1

Silent giant ureteric calculus in a child (a case report).

How to cite this article:
Yadav K K, Narasimharao K L. Silent giant ureteric calculus in a child (a case report). J Postgrad Med 1984;30:60

How to cite this URL:
Yadav K K, Narasimharao K L. Silent giant ureteric calculus in a child (a case report). J Postgrad Med [serial online] 1984 [cited 2022 Jun 27];30:60. Available from:

  ::   Introduction Top

The ureteral stones are usually small and about 50% of them are less than 5 mm in diameter.[3] Burkland[2] could find in the literature, reports of only 29 ureteric stones measuring more than 5 cm in length or diameter. We report a child with a large but silent ureteral calculus for its rarity and unusual presentation.

  ::   Case report Top

A 7 year old boy presented with poor general health, loss of weight and oedema of face of 6 months' duration. The child was ill nourished and anaemic. The abdomen was unremarkable. The urine had traces of albumin and a, few pus cells but was sterile on culture. The blood urea was 247 mg% and serum creatinine 6 mg%. The plain radiograph of the abdomen showed a dense calcified shadow in the left and a very small opacity in the line of the lower right ureter. The child was dialysed and an infusion pyelogram showed right sided hydronephrosis. There was a small radio-opaque shadow in the line of the lower ureter. The left kidney was poorly functioning and a large radio-opaque calculus was seen in the lower ureter. The metabolic workup was within normal limits. Bilateral ureterolithotomy was performed. The left ureter was exceedingly thickened and uniformly dilated.
The size of the stone from the left ureter was 7 x 3 x 2.5 cm. A 6F catheter could not be negotiated through the left ureterovesical opening, which necessitated cystotomy and meatotomy of the orifice. The post-operative recovery was uneventful. An IVP done 3 weeks after the operation showed regression of hydronephrosis on the right side and improved function in the left kidney.

  ::   Discussion Top

The concretions which exceed 5 cm in size were termed giant ureteric calculi[5] and are rare.[1] It is exceedingly rare to have these giant stones in the paediatric age. The largest calculus so, far reported was by Mayers[4] which measured 11 x 5.5 x 5 cm and weighed 286 gm, while the longest stone reported was by Taylor,[6] which was 21.5 cm in length.
Gross derangement of renal function without any abdominal symptoms was the presenting feature in the present case. Partial obstruction at the vesicoureteral orifice was responsible for the giant calculus in this child, which required surgical correction at the time of calculus removal, to avoid recurrence.

  ::   References Top

1.Ananthakrishnan, N. and Kapur, 13. M. L.: Giant ureteric calculus. Aust. N. Z. J. Surg., 45: 74-76, 1975.  Back to cited text no. 1    
2.Burkland, C.: Fracture of giant ureteric calculus. J. Urol., 69: 366-371, 1953.   Back to cited text no. 2    
3.Douramashkin, R. L.: Cystoscopic treatment of stone in ureter with special reference to large calculi based on study of 1550 cases. J. Urol., 54: 245-283, 1945.  Back to cited text no. 3    
4.Mayers, M. M.: Giant ureteric calculus (Weight: 286 grammes). J. Urol., 44: 47-53, 1940.  Back to cited text no. 4    
5.Muschat, M. and Kaplan, H.: The formotion of large stones within the ureter. Urol. and Cutan. Rev., 41: 153-157, 1937.Quoted by Ananthakrishnan and Kapur.   Back to cited text no. 5    
6.Taylor, W. N.: Large ureteric calculi; Report of a case. J. Urol., 32: 93-102, 1934.  Back to cited text no. 6    

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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow