A Severely Encrusted Forgotten Double J Ureteral Catheter

Double J (DJ) stents provide efficient upper urinary system drainage in patients with ureteral obstruction [1]. Long-term indwelling DJ stents may be complicated by encrustation and stone formation. Patients should have their DJ stents replaced every three months [2]. Plain abdominal radiography and computed tomography are the imaging methods of choice in these patients for making a diagnosis and guiding the therapy.

Herein we present the demonstrative images of a 62-year-old male who presented with fever (38.5°C) and flank pain and who had a history of nephrolithotomy with DJ stent placement seven years ago. Plain X-ray and abdominal computed tomography images revealed bilateral nephrolithiasis forming staghorn calculi in the right kidney and a left DJ stent fully covered with dense calcifications (Figure 1, 2). In the bladder, the distal hook of the stent was covered with a huge calcification, resulting in a “hockey-stick” appearance. The stent was completely encrusted. Laparoscopic removal of the device was considered, but the patient declined receiving any further intervention.

Figure 1.

Plain X-ray image revealing bilateral nephrolithiasis (short arrows) and the encrusted DJ catheter surrounded by dense calcifications (arrow heads). A large bladder calculus was also noted (long arrow).

Figure 2.

Volume rendering reformatted image of the patient.