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

Affiliations
  • 1Department of Urology, Yeungnam University College of Medicine, Daegu, Korea. junghc@ynu.ac.kr
  • 2Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
  • 3Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea.

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

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

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

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

  • 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.

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


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