Intraparenchymal hematoma as a late complication of retrograde intrarenal surgery
Int. braz. j. urol; 43 (2), 2017
Publication year: 2017
ABSTRACT A 34 year-old woman was admitted to our hospital with left flank pain. A non-contrast enhanced computerized tomography (NCCT) revealed a 1.5x2cm left proximal ureter stone. Patient was scheduled for ureterorenoscopy (URS) and stone removal. She was submitted to retrograde intrarenal surgery (RIRS). At the postoperative 1st day, the patient began to suffer from left flank pain. A NCCT was taken, which revealed a subcapsular hematoma and perirenal fluid. The patient was managed conservatively with intravenous fluid, antibiotic and non-steroidal anti-inflammatory drug therapy and was discharged at the postoperative 6th day. Two weeks after the discharge the patient was admitted to emergency department with severe left flank pain, palpitation and malaise. KUB (kidney-ureter-bladder) radiography showed double-J stent (DJS) to be repositioned to the proximal ureter. Patient was evaluated with contrast enhanced CT which revealed an 8cm intraparenchymal hematoma/abscess in the middle part of the kidney. A percutaneous drainage catheter was inserted into the collection. The percutaneous drainage catheter and the DJS were removed at the 10th day of second hospitalization. RIRS surgery is an effective and feasible choice for renal stones with high success and acceptable complication rates. However, clinician should be alert to possible complications.
Hematoma/diagnóstico por imagen, Hematoma/etiología, Enfermedades Renales/diagnóstico por imagen, Enfermedades Renales/etiología, Tejido Parenquimatoso/diagnóstico por imagen, Tejido Parenquimatoso/lesiones, Complicaciones Posoperatorias/diagnóstico por imagen, Presión, Stents/efectos adversos, Ureterolitiasis/complicaciones, Ureterolitiasis/cirugía, Ureteroscopios/efectos adversos, Ureteroscopía/efectos adversos