Affordable Access

Publisher Website

Intravenous Misplacement of the Nephrostomy Catheter Following Percutaneous Nephrostolithotomy: Two Case Reports

Fundacao Faculdade de Medicina
Publication Date
DOI: 10.1590/s1807-59322009000100013
  • Letter To The Editor
  • Medicine


69 CLINICS 2009;64(1):69-70 LETTER TO THE EDITOR Division of Urology, Hospital das Clínicas, Faculdade de Medicina, Univer- sidade de São Paulo - São Paulo/SP, Brazil. Email: [email protected] Tel.: 55 11 3069.8080 InTRavEnOus mIspLacEmEnT Of THE nEpHROsTOmy caTHETER fOLLOwIng pERcuTanEOus nEpHROsTOLITHOTOmy: TwO casE REpORTs doi: 10.1590/S1807-59322009000100013 Eduardo Mazzucchi, Anuar Mitre, Artur Brito, Marco Arap, Claudio Murta and Miguel Srougi INTRODUCTION Percutaneous nephrostolithotomy (PCNL) was introduced by Fernström and Johansson in 1976,1 and it has remained an important approach for removing kidney stones since its inception. A nephrostomy tube is routinely positioned in the renal pelvis in order to tamponade bleeding and drain the collecting system. Although PCNL is an established procedure, major complication rates of up to 7% have been reported.2 We report two cases of an uncommon PCNL complication and details of how we managed these cases with successful outcomes. CASE REPORT Case 1 - A 52-year-old male who had previously undergone a right open nephrectomy of a non-functioning kidney 10 years prior underwent a left PCNL. Serum creatinine (SCr) before surgery was 1.0 mg/dl (normal range 0.6-1.4 mg/dl). Access to the excretory system was achieved using fascial dilators, and a safety guide wire was used during the procedure. Intense bleeding led to a sudden interruption of the procedure; a nephrostomy tube was inserted and closed in order to control bleeding within the excretory system. An antegrade nephrostogram was not performed due to intense bleeding. An arteriography was performed and showed no abnormalities. After transfusion of two units of blood, the patient remained hemodinamically stable and urine was eliminated only by means of the urethral catheter. The nephrostomy tube remained closed. A magnetic resonance scan performed 72 hours later showed the nephrostomy tube in the left renal vein (Figure 1). The patient w

There are no comments yet on this publication. Be the first to share your thoughts.