A young female of around 30 year presented with complain of pain in rt lumbar region radiating down. On workup found to be rt distal ureteric calculus with shattered rt kidney (phlegmon formation). An open rt nephrectomy was done withot any intervention for ureteric stone due to anethetic complications during surgery.
Later on after 15 days postoperatively pt presented back with complain of recurrent vomiting not controlled by antiemetic, raised direct and indirect bilirubin and pain in rt lower abdomen and back. Pt also complained of associated hematuria after 2 days of admission. Usg abdomen and Viral markers were normal.Bilirubin also return to normal in 4 days. Patient was relieved of hematuria by conservative management in a day or two but HB is on falling trends even after repeated transfusion. Impacted VUJ Stone of same side doesn't seem to be cause for this much fall in HB to me.. what are other possible reasons for thus patient.pls give your opinion.