Abstract
CT-guided percutaneous renal access has been described as a safe and effective access technique in patients with complex anatomy, including ectopic kidney, retrorenal colon, spinal dysraphism, hepatomegaly, and splenomegaly. In comparison to conventional intraoperative fluoroscopic-guided access, CT imaging allows for delineation of surrounding structures that are at risk for injury during percutaneous access. However, previous reports indicate that pelvic kidneys might be inaccessible percutaneously without laparoscopic assistance. Herein, we present a novel transgluteal route to renal access for percutaneous nephrolithotomy (PCNL) in a patient with a pelvic horseshoe kidney and severe spinal deformity.
Highlights
CT-guided percutaneous renal access has been described as a safe and effective access technique in patients with complex anatomy, including ectopic kidney, retrorenal colon, spinal dysraphism, hepatomegaly, and splenomegaly
A CT scan (Fig. 1) revealed a pelvic horseshoe kidney with significant bilateral hydronephrosis resulting from a 3.3 cm obstructing stone in the right ureteropelvic junction (UPJ) and several stones in the left renal pelvis and ureter measuring up to 1.5 cm
She underwent bilateral retrograde ureteral stent placement at that time. She received supportive care and was discharged home after a 10-day hospitalization. She subsequently returned to the urology clinic for a discussion of possible treatment options, including bilateral percutaneous nephrolithotomy (PCNL)
Summary
MD,[2] Nadya York, MD,[2] Aashish A. MD,[3] and James E.
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