Korean J Urogenit Tract Infect Inflamm.  2014 Apr;9(1):56-59. 10.14777/kjutii.2014.9.1.56.

Renal Venous Perforation during Reinsertion of a Percutaneous Nephrostomy Catheter

• Song PH
• Ko YH
• Ok BG
• Kim YU
• Lee KS
• Kwon DH
• Kim HT
• Park SY
• Jung HC

• KMID: 1921579
• DOI: http://doi.org/10.14777/kjutii.2014.9.1.56

Abstract

While the sustainment of percutaneous nephrostomy with regular change in chronic un-operable cases is widely performed for relief of urinary obstructions, performance of the blind procedure without fluoroscopic monitoring could result in clinical disaster. We report on a case of direct renal vein injury by mis-guidance of a nephrostomy catheter, which was successfully managed conservatively by serial venography monitoring combined with intensive conservative treatment. To the best of our knowledge, this is the first report on management of a renal vein injury during the percutaneous nephrostomy.

Keyword

Percutaneous nephrostomy; Renal veins; Phlebography

MeSH Terms

Catheters*
Disasters
Nephrostomy, Percutaneous*
Phlebography
Renal Veins

Figure

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  Fig. 1. A renal computed tomography image taken 6 hours after the percutaneous nephrostomy change showed the nephrostomy catheter located in left renal vein.

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  Fig. 2. Initial venography taken 72 hours after percutaneous nephrostomy catheter insertion.

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  Fig. 3. Follow up venography taken 120 hours after percutaneous nephrostomy catheter insertion showed the catheter located near the bifurcation of renal vein.

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  Fig. 4. Additional soft guide wire was placed in the catheter prior to removal to minimize additional injury from the terminal angled loop of percutaneous nephrostomy catheter.

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  Fig. 5. The venography right after removal of the percutaneous nephrostomy catheter revealed the renal pelvis filled with contrast media.

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