Management of a nephrostomy tube misplacement into the inferior vena cava following PCNL

A 50-year-old female with left flank pain and 3.1 cm renal calculi underwent PCNL. Intraoperatively, an anatomical variant led to accidental insertion of a nephrostomy tube into the inferior vena cava (IVC), while a second tube was correctly placed. Postoperative edema prompted CT imaging revealing...

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Bibliographic Details
Main Authors: Zhuoran Gu, Tantu Ma, Wentao Zhang, Lei Jiang, Xudong Yao, Yifan Chen
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Urology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214442025001159
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Summary:A 50-year-old female with left flank pain and 3.1 cm renal calculi underwent PCNL. Intraoperatively, an anatomical variant led to accidental insertion of a nephrostomy tube into the inferior vena cava (IVC), while a second tube was correctly placed. Postoperative edema prompted CT imaging revealing the malposition. The misplaced tube was incrementally withdrawn under CT guidance over days to prevent bleeding complications, then repositioned successfully. Three-month follow-up confirmed resolution of hydronephrosis, absence of strictures or bleeding, and complete wound healing. This case underscores the necessity of intraoperative anatomical vigilance and staged management of iatrogenic vascular injuries during PCNL.
ISSN:2214-4420