Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy
Background. Gaining percutaneous access during percutaneous nephrolithotomy (PNL) can be complicated with the bowel injury. We report a novel approach of management of duodenal injury complicating percutaneous drainage of infected haematoma after Shock-Wave Lithotripsy (SWL). Case Presentation. A 57...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Urology |
| Online Access: | http://dx.doi.org/10.1155/2018/2020572 |
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| author | Nariman Gadzhiev Dmitry Gorelov Alexander Smirnov Salman Al-Shukri Sergei Petrov |
| author_facet | Nariman Gadzhiev Dmitry Gorelov Alexander Smirnov Salman Al-Shukri Sergei Petrov |
| author_sort | Nariman Gadzhiev |
| collection | DOAJ |
| description | Background. Gaining percutaneous access during percutaneous nephrolithotomy (PNL) can be complicated with the bowel injury. We report a novel approach of management of duodenal injury complicating percutaneous drainage of infected haematoma after Shock-Wave Lithotripsy (SWL). Case Presentation. A 57-year-old patient with the 15 mm right pelvic kidney stone underwent uneventful SWL. Patient visited emergency department 3 days later with high fever and chills with severe right flank pain. CT urography revealed lower pole kidney injury with signs of infected hematoma due to low attenuation areas but without signs of obstruction or urine leakage. Infected haematoma was drained percutaneously under ultrasound and X-ray control and a pigtail catheter 10 Fr was left beneath the lower pole of the right kidney. Postoperatively duodenal injury was suspected due to amber color, low creatinine, and high bilirubin level in the drainage output. CT demonstrated that the pigtail of the drain had entered the second part of the duodenum. Catheter was withdrawn and defect of the duodenal wall was stapled with four staples endoscopically. After 2 days of fasting patient was allowed to start oral food intake and was discharged on the 5th day. Conclusion. Injury of the duodenum during percutaneous kidney manipulation is an extremely rare complication. Conservative management consisting of endoscopic stapling of the duodenal wall defect is a safe and feasible approach to expediting the recovery of the patient. |
| format | Article |
| id | doaj-art-0b597ac8623d4d70aa10e7abf0e84ef6 |
| institution | Kabale University |
| issn | 2090-696X 2090-6978 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Urology |
| spelling | doaj-art-0b597ac8623d4d70aa10e7abf0e84ef62025-02-03T01:11:50ZengWileyCase Reports in Urology2090-696X2090-69782018-01-01201810.1155/2018/20205722020572Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave LithotripsyNariman Gadzhiev0Dmitry Gorelov1Alexander Smirnov2Salman Al-Shukri3Sergei Petrov4Department of Urology, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, RussiaDepartment of Urology, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, RussiaDepartment of Endoscopy, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, RussiaDepartment of Urology, Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, RussiaDepartment of Urology, The Nikiforov Russian Center of Emergency and Radiation Medicine, Saint-Petersburg, RussiaBackground. Gaining percutaneous access during percutaneous nephrolithotomy (PNL) can be complicated with the bowel injury. We report a novel approach of management of duodenal injury complicating percutaneous drainage of infected haematoma after Shock-Wave Lithotripsy (SWL). Case Presentation. A 57-year-old patient with the 15 mm right pelvic kidney stone underwent uneventful SWL. Patient visited emergency department 3 days later with high fever and chills with severe right flank pain. CT urography revealed lower pole kidney injury with signs of infected hematoma due to low attenuation areas but without signs of obstruction or urine leakage. Infected haematoma was drained percutaneously under ultrasound and X-ray control and a pigtail catheter 10 Fr was left beneath the lower pole of the right kidney. Postoperatively duodenal injury was suspected due to amber color, low creatinine, and high bilirubin level in the drainage output. CT demonstrated that the pigtail of the drain had entered the second part of the duodenum. Catheter was withdrawn and defect of the duodenal wall was stapled with four staples endoscopically. After 2 days of fasting patient was allowed to start oral food intake and was discharged on the 5th day. Conclusion. Injury of the duodenum during percutaneous kidney manipulation is an extremely rare complication. Conservative management consisting of endoscopic stapling of the duodenal wall defect is a safe and feasible approach to expediting the recovery of the patient.http://dx.doi.org/10.1155/2018/2020572 |
| spellingShingle | Nariman Gadzhiev Dmitry Gorelov Alexander Smirnov Salman Al-Shukri Sergei Petrov Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy Case Reports in Urology |
| title | Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy |
| title_full | Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy |
| title_fullStr | Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy |
| title_full_unstemmed | Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy |
| title_short | Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy |
| title_sort | novel approach for endoscopic management of duodenal injury during perirenal infected haematoma drainage after shock wave lithotripsy |
| url | http://dx.doi.org/10.1155/2018/2020572 |
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