Imagen médica- Litiasis coraliforme completa: indicación de nefrectomía ante compromiso funcional severo

Abstract

33-year-old female patient with a history of arterial hypertension and a two-year evolution of right complete staghorn calculus, associated with multiple hospitalizations due to recurrent urinary tract infections. A renal scintigraphy with DTPA and diuretic showed a relative GFR of 34% in the right kidney with severe, non-reversible obstruction. A contrast-enhanced CT scan revealed severe hydronephrosis and cortical thinning secondary to the complete staghorn calculus. An elective right simple nephrectomy was performed. During surgery, the right kidney measured approximately 10 cm. A direct incision was made into the specimen, confirming the presence of a complete staghorn calculus occupying the entire pelvicalyceal system. Histopathological examination revealed interstitial nephritis and atrophy, consistent with chronic parenchymal damage. The postoperative course was satisfactory, and the patient was discharged with follow-up by urology, nephrology, and psychology.