Presentation on theme: "The physical characteristics of urinary calculi (1) Calcium phosphate stones (2) Magnesium ammonium phosphate stones (3)Calcium oxalate stones "— Presentation transcript:
The physical characteristics of urinary calculi (1) Calcium phosphate stones (2) Magnesium ammonium phosphate stones (3)Calcium oxalate stones (4) Cystine stones (5) Uric acid stones: they can not be seen on plain X-ray films
Pathology The size, number and position of the stone goven the development of secondary pathologic changes in the urinary tract. The major cause of progressive renal damage is the renal infection
The ureter is narrow at 3 points A. at the ureteropelvic junction B. at the point where the ureter crosses over the iliac vessels 4mm C. in the ureterovesical zone 1-5 mm
Nausea and vomiting Abdominal distention from paralytic ileus Chills, high fever and vesical irritability are due to infection
The history should include a survey of fluid intake, diet,drugs,periods of immobilization, pervious passage of stones and the presence of gout.
If the stones is still submucosal or adherent to the pareachyma, there are no symptoms. Staghorn calculus maybe asymptomatic.
B. Signs: Tenderness in the costovertebral angle or over the kidney may or may not be present. If marked hydronephrotic atrophy has occurred, a mass in the flank may be seen, felt or percussed.
C. Laboratory Findings: 1. Blood count 2. Urinalysis 3. Renal function tests: –Determination of the tubular reabsorption of phosphate (TRP) may prove helpful in the diagnosis of hyperparathyroidism when minimal hypercalcemia and normal blood phosphate levels are obtained.
D. X-rays Findings: At least 90% of renal stonesare radiopaque. KUB+IVP (excretory urograms) are necessary because they accurately localize the calcific shadow. If renal function is poor, retrograde urograms may be needed.
E. Ultrasonography: were able to distinguish between opaque and nonopaque stones.