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Intrarenal pseudoaneurysm after percutaneous nephrolithotomy at solitary kidney.

Ozturk H - Nephrourol Mon (2014)

Bottom Line: In the presented patient, serious retroperitoneal hemorrhage and hypotension in the preoperative and postoperative periods resulted in acute renal failure (ARF).It was first report of selective TAE in a patient with ARF due to post-PCNL pseudoaneurysm in solitary kidney.Super-selective segmental embolization was performed successfully in this case and was shown to be a reliable and efficient procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, School of Medicine, Sifa University, Izmir, Turkey.

ABSTRACT

Introduction: Percutaneous nephrolithotomy (PCNL) is a standard, safe, and efficient method for removing large renal calculi. Despite development of endourologic equipment, complications of the PCNL are still prevalent. Even though therapeutic modalities such as mini-micro PCNL have been developed in recent years, the complications are a serious concern yet. The most important complication is hemorrhage. The hemorrhage may be either arterial or venous. Venous hemorrhage is usually treated conservatively whereas the arterial one might require transarterial embolization (TAE). Arterial hemorrhage may cause serious problems, especially in the patients with solitary kidney.

Case presentation: In the presented patient, serious retroperitoneal hemorrhage and hypotension in the preoperative and postoperative periods resulted in acute renal failure (ARF).

Conclusions: It was first report of selective TAE in a patient with ARF due to post-PCNL pseudoaneurysm in solitary kidney. Super-selective segmental embolization was performed successfully in this case and was shown to be a reliable and efficient procedure.

No MeSH data available.


Related in: MedlinePlus

Intravenous Pyelogram showing a Twenty-seven-millimeter Calculus in the Left Kidney.
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fig12937: Intravenous Pyelogram showing a Twenty-seven-millimeter Calculus in the Left Kidney.

Mentions: A 27-year-old man presented with left flank pain. On the hemogram, he had white blood cell of 7000/mm3, hemoglobin (Hb) of 16.6 g/dL, hematocrit of 49.6%, and platelet of 193000/mm3. Bleeding time, coagulation time, prothrombin time, and activated partial thromboplastin time values were within normal limits. Laboratory investigations were as follows: Urea, 32 mg/dL; and creatinine, 0.8 mg/dL. The results of liver function tests were within normal limits. On physical examination, tenderness was found on the left lumbar region. Examination findings of other organ-systems were normal. Ultrasonography (US) findings revealed the agenesis of the right kidney, the size of left kidney was 151 × 71 mm, its parenchymal thickness was 22 mm, and there was a 27 mm calculus in the major lower calyx. On the intravenous pyelogram, the left kidney stone was 27 mm in size and the nephrogram and pyelogram findings were insignificant (Figure 1). No activity was observed in the right kidney. Diagnosis of the solitary kidney was confirmed by DTPA and DMSA.


Intrarenal pseudoaneurysm after percutaneous nephrolithotomy at solitary kidney.

Ozturk H - Nephrourol Mon (2014)

Intravenous Pyelogram showing a Twenty-seven-millimeter Calculus in the Left Kidney.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318009&req=5

fig12937: Intravenous Pyelogram showing a Twenty-seven-millimeter Calculus in the Left Kidney.
Mentions: A 27-year-old man presented with left flank pain. On the hemogram, he had white blood cell of 7000/mm3, hemoglobin (Hb) of 16.6 g/dL, hematocrit of 49.6%, and platelet of 193000/mm3. Bleeding time, coagulation time, prothrombin time, and activated partial thromboplastin time values were within normal limits. Laboratory investigations were as follows: Urea, 32 mg/dL; and creatinine, 0.8 mg/dL. The results of liver function tests were within normal limits. On physical examination, tenderness was found on the left lumbar region. Examination findings of other organ-systems were normal. Ultrasonography (US) findings revealed the agenesis of the right kidney, the size of left kidney was 151 × 71 mm, its parenchymal thickness was 22 mm, and there was a 27 mm calculus in the major lower calyx. On the intravenous pyelogram, the left kidney stone was 27 mm in size and the nephrogram and pyelogram findings were insignificant (Figure 1). No activity was observed in the right kidney. Diagnosis of the solitary kidney was confirmed by DTPA and DMSA.

Bottom Line: In the presented patient, serious retroperitoneal hemorrhage and hypotension in the preoperative and postoperative periods resulted in acute renal failure (ARF).It was first report of selective TAE in a patient with ARF due to post-PCNL pseudoaneurysm in solitary kidney.Super-selective segmental embolization was performed successfully in this case and was shown to be a reliable and efficient procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, School of Medicine, Sifa University, Izmir, Turkey.

ABSTRACT

Introduction: Percutaneous nephrolithotomy (PCNL) is a standard, safe, and efficient method for removing large renal calculi. Despite development of endourologic equipment, complications of the PCNL are still prevalent. Even though therapeutic modalities such as mini-micro PCNL have been developed in recent years, the complications are a serious concern yet. The most important complication is hemorrhage. The hemorrhage may be either arterial or venous. Venous hemorrhage is usually treated conservatively whereas the arterial one might require transarterial embolization (TAE). Arterial hemorrhage may cause serious problems, especially in the patients with solitary kidney.

Case presentation: In the presented patient, serious retroperitoneal hemorrhage and hypotension in the preoperative and postoperative periods resulted in acute renal failure (ARF).

Conclusions: It was first report of selective TAE in a patient with ARF due to post-PCNL pseudoaneurysm in solitary kidney. Super-selective segmental embolization was performed successfully in this case and was shown to be a reliable and efficient procedure.

No MeSH data available.


Related in: MedlinePlus