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Thank you Dr. Tharun,
His creatinine was 1.1 which is considered normal.
Is it reasonable to expect a 6mm stone to pass with no surgical intervention?
I fell like there was no real physical assessment performed. Due to the extreme pain they rushed him back. The ED touched his flank area and that was the extent. There were no questions regarding his history of MS; whether he had problems urinating which MS can affect.
The problem is that in the dictation by the ED doctor he did not mention the steroids or oxycontin and morphine he was on for pain almost daily for Multiple Sclerosis...the H&P was incomplete..are there instances in which a patient is admitted for stents for this? Doesn't the hydronephrosis indicate a potential problem?
Thank you for your help.
Thank you, XXXXX XXXXX
The presence of infection in and of itself with a stone would not necessitate further treatment in a patient with history of an immunocomprimised status?
You have helped clear my questions and thank you very much!
There was a block in the ureter; a 6mm stone and a 4mm stone plus the infection. If I am understanding your reply correctly, given the block and infection stents should have been placed? The urine showed infection plus increased WBC. The scan showed the stones and hydronephrosis. The doctor knew he had MS.
Do you think the fact that the creatinine was normal and he was afebrile was the reason he was discharged? I guess I feel you have to look at the whole picture and am trying to wrap my brain around the rationale for discharge so quickly.