case_images: PMC6461058_01
case_images: Preoperative stone burden.
case_images: fig-1.jpg
case_images: PMC6461058_01_fig-1.jpg
case_images: f1
case_images: She presented to our outpatient clinic initially in consultation for left-sided abdominal pain, and subsequent CT scan revealed nephrolithiasis with three separate left ureteral stones (Fig. 1), requiring urgent ureteral stent placement.
case_images: Poor intraoperative observation.
case_images: fig-2.jpg
case_images: PMC6461058_01_fig-2.jpg
case_images: f2
case_images: During her planned second stage PCNL, initial ureteroscopic observation was very poor because of extensive clot burden in the right renal pelvis and calices (Fig. 2).
case_images: Intraoperative CT angiography.
case_images: fig-3.jpg
case_images: PMC6461058_01_fig-3.jpg
case_images: f3
case_images: Ultimately the CTA revealed no evidence of pulmonary thrombus; however, abdominal follow-through was notable for extensive air in the right renal collecting system (Fig. 3).