Metachronous renal vein and artery injure after percutaneous nephrostolithotomy

BMC Urology

Case Report

Chaojun Wang¹  Fuqing Tang¹  Shanwen Chen¹  Baihua Shen¹ 

[1] Department of Urology, the First Affiliated Hospital, Medical of College, Zhejiang University, No. 79 Qing Chun road, 310003, Hangzhou, China;

关键词: Percutaneous nephrostolithotomy;    Misplacement;    Pseudoaneurysm;    Computed tomography angiography;   

DOI  :  10.1186/1471-2490-13-69

 received in 2013-07-29, accepted in 2013-11-27,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundPercutaneous nephrostolithotomy is important approach for kidney stones removal. A percutaneous nephrostomy drainage tube placement is an effective method to stop venous bleeding. Occasionally, the catheter can pierce into the renal parenchyma, and migrate into the renal vein even to the vena cava.Case presentationA 66-year-old woman underwent a percutaneous nephrostolithotomy for kidney staghorn stone complicating severe bleeding. A computed tomography angiography showed the percutaneous nephrostomy drainage tube inside the renal vein. The percutaneous nephrostomy drainage tube was withdrawn 3 cm back to the renal parenchyma/sinus/pelvis in stages with the surgical team on standby. Seven days later, the patient developed severe hematuria. Computed tomography angiography demonstrated the pseudoaneurysm located near the percutaneous nephrostomy drainage tube. Pseudoaneurysm is embolized successfully.ConclusionOur case shows intravenous misplacement of the nephrostomy tube and subsequent pseudoaneurysm after percutaneous nephrostolithotomy. To our knowledge, this seems to be the first documentation of major bleeding from the injury to both renal vein and artery. The percutaneous nephrostomy drainage tube can be withdrawn back to the renal parenchyma/sinus/pelvis in stages with the surgical team on standby, and the withdrawn distance may vary according to patient and catheter position.

【 授权许可】

Unknown   
© Wang et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.