Abstract
Herein, we reported a duodenal perforation case as an intestinal injury during a percutaneous nephrostomy procedure. A 73-year-old woman with bilateral nephrostomy catheters was applied to the emergency service with right flank pain. Early in the day, her bilateral nephrostomy catheters had been changed. On physical examination, she had a defense and rebound at her right quadrant, and costovertebral angle tenderness was also positive. In the contrast-enhanced abdominal computed tomography scan, the right nephrostomy catheter was located in the second part of the duodenum, and the contrast agent did not leak into the peritoneum from the injury area. We decided on conservative management of the case with active surveillance using daily blood tests and physical examinations. The nephrostomy catheter in the duodenum was left to prevent fistula between the duodenum and the skin, and a new one was placed in the right kidney. The broad spectrum antibiotherapy regime was applied, and the patient was followed up closely. The catheter in the duodenum was removed on the 20th day, uneventfully, and the patient was discharged successfully on the 24th day with her permanent bilateral nephrostomy tubes. On the first follow-up, one month later, the patient had no active medical complaint.
Highlights
Percutaneous nephrostomy (PCN) is an interventional method of accessing the renal collecting system through the skin
Intestinal complications are commonly associated with percutaneous nephrolithotomy, and to our knowledge, there is only one case with an intestinal complication in the form of duodenal perforation during PCN procedure without renal stone fragmentation [3]
The PCN procedure was firstly described by Goodwin et al [4] in 1955, and it has become one of the most common urological procedures in clinical practice [2]
Summary
Percutaneous nephrostomy (PCN) is an interventional method of accessing the renal collecting system through the skin. It is a commonly used treatment approach in patients with urinary obstruction, especially when ureteral stent replacement is not possible [1, 2]. Some major and minor complications can occur [1, 2]. Sepsis and massive bleeding are the most common major complications associated with PCN [2]. Intestinal complications are commonly associated with percutaneous nephrolithotomy, and to our knowledge, there is only one case with an intestinal complication in the form of duodenal perforation during PCN procedure without renal stone fragmentation [3]. After obtaining written informed patient consent, we report the second case of duodenal perforation as an intestinal injury during PCN
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
