Giant Mixed Vesical Calculus in a Patient in North Central, Nigeria: A Case Report

A 30-year old male Business man presented at the accident and emergency unit of Abnira Medical Centre in Jos city on account of inability to pass urine for over fifteen hours. There was concomitant excruciating lower abdominal pain and swelling that is tender to touch. A positive history of generalized weakness, fatigue, nausea, heamaturia was given. However, no fever, vomiting, headache nor history of fainting attacks. On examination, he was afebrile, acyanosed with associated tachycardia (pulse rate 121bpm) and tachypnea (respiratory rate of 27c/min).He was oriented in place, person and time with no focal neurological deficit. There were no cardiac and other respiratory signs picked on examination. His abdomen was soft and non-tender, with normal bowel sounds. However, there was renal angle tenderness. Biochemical investigations done on presentation showed normal sodium, potassium, chlorite, and bicarbonate. He has some evidence of dehydration and pre-renal azotemia (increased creatinine, urea and uric acid).His liver function tests, lipase, thyroid function test, phosphate, magnesium and albumin-corrected calcium were all normal.