Staghorn calculi


Staghorn calculi

Description, Causes and Risk Factors:

Alternative Name: Struvite stones

A calculus occurring in the renal pelvis, with branches extending into the infundibula and calices.

Staghorn calculi are a type of kidney stone that may occur with frequent kidney infections. They are called "staghorn" calculi because on X-rays they look like deer (stag) horns. These stones are mainly composed of ammonium and magnesium phosphate and resemble hard crystals. Fewer than 10% of the people who have kidney stones have this type of stone.

Staghorn calculi are formed due to urinary tract bacterial infections. The common organisms include - Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella, Providencia, Serratia, and staphylococci. Genetic factors may play a role in about half of these cases. A number of medical conditions and drugs can also affect digestion and intestinal absorption.

Risk Factors:

    Obesity and weight gain are both associated with an increased risk.

  • Higher BMIs and larger waist circumferences are also risk factors.

  • People whose diets are high in animal protein and low in fiber and fluids may be at higher risk for these stones.

  • One study reported that people who had a major stressful life experience were more likely to develop stones.

  • Any medical or physical condition that keeps a person in bed or immobile increases blood levels of calcium from bone breakdown, thereby posing a risk for stone formation.

Staghorn calculi can be more serious because they are large stones and an infection may be present. Medical treatment, including antibiotics and surgical removal of the stone, is usually needed. Women are affected more than men because of their higher risk for urinary tract infections.

Symptoms:

    Tiny stones may cause no symptoms, but larger stones can cause excruciating pain in the area between the ribs and hips.

  • Pain in the lower abdomen.

Other symptoms may include:

    Nausea and vomiting.

  • Restlessness.

  • Sweating.

  • Blood in the urine.

  • A person may have an urge to urinate frequently.

  • Chills and fever sometimes occur.

Diagnosis:

The disease is difficult to diagnose as many conditions can cause symptoms similar to struvite stones.

Urine Test: Urine samples are required to evaluate features of the urine, including its acidity and the presence of red or white blood cells, infection, crystals, high or low levels of chemicals that inhibit or promote stone formation.

Blood Test: Blood tests may help determine blood levels of urea nitrogen, creatinine, calcium, phosphate, and uric acid for patients with known or history of kidney stones.

Imaging Techniques:

    X-Rays: A standard x-ray of the kidneys, ureters, and bladder may be a good first step for identifying stones.

  • Spiral or Helical Computed Tomography: A type of computed tomography (CT) scan called a spiral or helical CT scan is currently the best method for diagnosing stones in either the kidneys or the ureters

  • Ultrasound: Ultrasound can detect clear uric acid stones and obstruction in the urinary tract.

  • Intravenous Pyelogram: In this test the doctor injects a special dye into the patient. A technician will then take x-rays as the dye enters the kidneys and travels down the urinary tract. IVP is invasive but, until recently, was the most cost-effective method for detecting stones.

Treatment:

Medical therapy alone cannot rid the patient of struvite calculi and are best managed with complete surgical removal of the stones. Urine acidifiers include specific tablets, animal proteins and citrus fruits. These risks are generally considered minor and complications associated with “cystotomy” are very unusual. The patient usually stays in the hospital a day or two to be sure urine production is normal, to properly confine the patient, and to assess pain.

Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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