Repeat lab work
Repeat lab work revealed a leukocytosis that was now 17.5 thou/µL. Given this finding and her persistent intermittent abdominal pain, a repeat CT scan was ordered. This showed the right ureteral stent in good position, improved hydronephrosis, and a markedly dilated appendix with surrounding stranding consistent with acute appendicitis (figures 3 and 4).
The patient was seen by general surgery and ultimately taken to the operating room for laparoscopic appendectomy. Intraoperatively, she was found to have a large, inflamed appendix with a perforation at the base and purulent ascites (figure 5). Her final urine culture was negative.
One month after the initial stent placement, the patient was re-evaluated. She was asymptomatic and KUB revealed no ureteral calcification. The stent was removed without issue.