Rare Stones

​A middle-aged traveler came to the emergency department with her son. He said his mother did not have a medical history because she rarely saw a doctor. She had been having intermittent abdominal pains, however, so he brought her to the emergency department.​There was little to go on, so why not try a bedside ultrasound to see if there are any clues? Surprisingly, shadowy objects showed up in the bladder.The abdominal flat plate confirmed two giant, egg-shaped bladder calculi. Bladder stones are uncommon, accounting for only five percent of all urinary tract stones. It is believed that bladder calculi have had a declining incidence in developed nations because of improved nutrition and UTI treatment. Unlike our patient, the vast majority of bladder stones are found in men. Most form because of bladder outlet obstruction, retention from a neurogenic bladder, or the presence of foreign bodies. Migrating suture materials from gynecologic surgery are thought to be a nidus for some calculi formation in women. Bladder stones have been associated with recurrent UTIs, bladder tumors, urinary retention, and renal failure.Given the unusual nature of this case, a CT was obtained. The thickened bladder walls went along with the chronic inflammation and the current urinary infection. She was ultimately discharged on a course of antibiotics with a urologic follow-up to arrange for stone removal.Take Home Tip: Ultrasound is a great bedside tool that may just lead you to an une...
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs