1242 A Surfacing Staghorn: Spontaneous Expulsion of a Large Renal Calculus from A Nephrocutaneous Fistula

Abstract An 83-year-old lady presented to the urology department with right flank pain in context of a previously known renal staghorn calculus. On examination, she was found have visible discharging sinus her flank, and calculus had become at skin surface. Non-contrast CT imaging confirmed that eroded through via nephrocutaneous fistula. The stone manually extracted percutaneously on ward, treated intravenous antibiotics. She subsequently passed further tract made good recovery. This is highly unusual presentation nephrolithiasis developed country 21st century. Review literature suggests surgical management almost always indicated patients calculi. However options are not without risk conservative disease may be appropriate select patient groups: those multiple co-morbidities high for GA, cases refusal surgery, or aberrant anatomical factors Our case highlights potential complication conservatively managed disease. To our knowledge first spontaneous expulsion this size reported world.