A boy with kidney stone managed with ESWL
Master S.K., was referred to us with pain on right side of tummy and hematuria (blood in urine) on and off for last one month.
 
Ultrasound scan showed a 1cm sized stone in the pelvis of right kidney. There was minimal hydronephrosis seen.
The child was planned for Extra-corporeal Shock Wave Lithotripsy (ESWL).
Under anesthesia, as a first step cystoscopy was done and a DJ stent (a small plastic pipe) was placed into kidney. This DJ stent allows the small stone fragments to be passed without much pain/ blockage.
The child was placed on the ESWL table under sedation (sleep). The x-ray machine and ESWL machine was focused on the stone and lithotripsy started. The stone was seen to fragment completely within 30 minutes.
Child was sent home in the evening of procedure. A check Ultrasound and x-ray 2 weeks later showed complete clearance of stone fragments and the DJ stent was removed.
 
Plain X-ray of tummy showing round 1 cm stone in right kidney Ultrasound showing 1 cm stone in right kidney
   
Child on ESWL table undergoing lithotripsy
   
About Extra-corporeal Shock Wave Lithotripsy (ESWL) in Children
ESWL involves using the shock waves to break the stone into pieces. These shock waves are generated in a machine and transmitted via a globe which is kept in contact with the kid’s body. ESWL is a completely non-invasive procedure and is practically pain free.
Advantages of ESWL
                Non-invasive- no cuts/ scars
                Painless
Disadvantages
                Can be used for stones only in selected locations
                Cant be used for stones bigger than 1.2 cm or multiple stones
                If the stone does not break, a endoscopic surgery may still be required.
 
 
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