Introduction:
Ankylosing spondylitis (AS) is a seronegative inflammatory disease that progressively affects the spine and sacroiliac joints. These patients often present with co-existing issues like bilateral hip replacements, nephrolithiasis, skin lesions, peripheral vascular disease and coronary artery disease. (1–5) It is, however, rare to find all of these in one single patient. We describe a patient with ankylosing spondylitis with bilateral hip replacements in the past who was waiting for an elective coronary artery bypass grafting (CABG) but needed urgent admission with renal colic and unstable angina. Synchronous CABG and ureteric stone retrieval along with DJ stent was successfully carried out in this patient with ankylosing spondylitis.