Imaging of forgotten indwelling D.J. stent with encrustment

A poor, uneducated male patient from a remote rural place had undergone Right open pyelolithotomy with Double J (D.J. stent) stenting for obstructive uropathy 15 years ago. He presented with the following prevailing conditions: right flank pain, interrupted urinary stream and burning micturition. Ultrasound showed Gross Hydronephrosis with multiple calculi and D.J. stent in the right kidney.

Urinary bladder also showed presence of D.J. stent with encrustment around the tip of the stent.

The mid part of D.J. stent was not visualized. Later, on X-ray, broken parts of the stent with encrustment were seen in the right renal pelvis and bladder, which were removed, and cystolithotomy was done. Imaging plays a pivotal role in detection of such broken or forgotten stents and can direct early and prompt management to prevent complications.