Multiple Kidney Calculi - Erler Zimmer 3D anatomy Series MP2095

This dissection model highlighting Multiple Kidney Calculi is part of the exclusive Monash 3D anatomy series, a comprehensive series of human dissections reproduced with ultra-high resolution color 3D printing.

Clinical history.

A 68-year-old man presented with fevers and chills. Further questioning reveals a 6-month history of bilateral intermittent flank pain and hematuria. Biochemical investigations revealed significantly reduced renal function with normal serum calcium. A CT scan of the abdomen showed bilateral hydronephrosis with multiple kidney stones and perinephric and subphrenic abscesses. He later died of progressive renal failure.

Pathology

The specimen is a patient's kidney, which is grossly and partially divided in two. Gross dilatation of the pelvic-caliceal system is visible. Significant atrophy of the renal tissue can be seen, in some places reduced to a simple border. A large mottled white-brown stone is located in the pelvis, and a smaller stone occludes the lumen of the ureter. The ureter is dilated proximally to the included calculus. There are multiple calculi visible within the calyces of the specimen.

Further information

Urolithiasis (kidney stones) is a very common disease that affects up to 1 in 10 people during their lifetime. Stone formation can occur anywhere along the urinary tract, but most commonly occurs within the kidneys. Risk factors for stone formation include male sex; any condition that affects urine composition, such as hypercalciuria or elevated urinary oxalate; systemic metabolic disorders, such as cystinuria and taste; dietary factors, such as high intake of oxalate and animal protein ??low fluid intake; and environmental factors, such as high dry temperatures. Eighty percent of kidney stones are unilateral.
Symptoms of urolithiasis include stabbing pain, hematuria, nausea, vomiting, fainting, dysuria, and urgency. Symptoms depend on the size and location of the stone. Urolithiasis can be asymptomatic especially if stones form and remain within the renal pelvis or bladder. Symptoms occur when the stones move into the ureter. Stone pain is usually colic and typically severe in nature; occurring in paroxysms. The flank is the most common site for pain, but pain can occur anywhere along the urinary tract and in the genitals. The pain resolves as the stone passes. Hematuria may be large or microscopic.

There are four main types of kidney stones:

Calcium stones are the most common and comprise 70% of all stones. They consist of calcium oxalate or a mixture with calcium phosphate. Hypercalciuria, hypercalcemia and hyperoxaluria are common causes of these stones.
Struvite stones make up 5-10% of the stones. They consist of magnesium ammonium phosphate. These commonly form as a result of proteus infections and lead to the formation of very large "staghorn" stones.
Trick uric acid stones 5-10% stones. These occur in patients with hyperuricemia, such as taste and chronic leukemia.
The rest is cysteine, which is due to reduced renal reabsorption of amino acids such as cystine.

Diagnosis can be made on the basis of history and examination. Radiological tools frequently used to aid diagnosis include CT scan without contrast medium or ultrasound of the kidneys and bladder. Less commonly used imaging methods include abdominal radiography, intravenous pyelogram, and MRI.
If untreated kidney damage and failure from progressive obstruction. Kidney stones also predispose patients to infection secondary to the obstruction and the trauma they cause. Treatment in acute patients includes supportive treatment to allow passage of the stone. Medical treatment used includes analgesia, commonly NSAIDs and opioids, and agents to promote stone passage, such as alpha-blockers, calcium channel blockers, and antispastics. Surgery may be necessary if there are serious complications from stones or if the stone is large and cannot be expelled with conservative treatment. Surgical interventions include lithotripsy (using laser or electricity), laparoscopic stone removal, or percutaneous stone removal. Rarely, open surgery is required.

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What advantages does the Monash University anatomical dissection collection offer over plastic models or plastinated human specimens?

• Each body replica has been carefully created from selected patient X-ray data or human cadaver specimens selected by a highly trained team of anatomists at the Monash University Center for Human Anatomy Education to illustrate a range of clinically important areas of anatomy with a quality and fidelity that cannot be achieved with conventional anatomical models-this is real anatomy, not stylized anatomy.
• Each body replica has been rigorously checked by a team of highly trained anatomists at the Center for Human Anatomy Education, Monash University, to ensure the anatomical accuracy of the final product.
• The body replicas are not real human tissue and therefore not subject to any barriers of transportation, import, or use in educational facilities that do not hold an anatomy license. The Monash 3D Anatomy dissection series avoids these and other ethical issues that are raised when dealing with plastinated human remains.