Large ureteric calculi and venous sinuses thrombosis of the brain led to behcet’s dis-ease diagnosis in a child: a story to tell

Paediatric ureteric calculi are an uncommon conditions encountered occasionally by adult urologists. Endoscopic treatment is the mainstay treatment of such cases. Neverthe-less, a significant percentage of children with ureteric calculi present with other comorbidi-ties which is usually overlooked by urologists. In this article, we describe a rare case of paediatric ureteric calculi associated with deep venous sinuses thrombosis of the brain eval-uated through a multidisciplinary approach that led to the final diagnosis of Behçet's dis-ease which is also a rare condition in paediatrics. The complexity of the case in view of the rarity of both diseases encouraged us to report it. We present an eight-year-old male re-ferred to a tertiary centre as a case of mastoiditis, complaining of severe headache, di-plopia, and high-grade fever. Magnetic resonance venography “MRV” with intravenous “IV” contrast showed left transverse sigmoid and internal jugular dural venous sinus thrombosis but no evidence of mastoiditis. Computed tomography “CT” scan of the abdo-men and pelvis showed a large left distal ureteric stones up to 4 cm collectively associated with hydronephrosis in addition to a few stones in the left kidney. He was managed by different teams such as urology, otorhinolaryngology, neurology, and ophthalmology to sort out his mysterious presentation over a lengthy hospital admission. Upon further evalua-tion and multi-disciplinary approach, a diagnosis of Behçet's disease has been made. Paedi-atric ureteric calculi are an uncommon problems and frequently presented with other comorbidities. Multi-disciplinary team approach to such cases is recommended and may uncover a serious underlying disease or concomitant comorbidities.