Journal List > Korean J Urogenit Tract Infect Inflamm > v.9(1) > 1059951

Song, Ko, Ok, Kim, Lee, Kwon, Kim, Park, and Jung: Renal Venous Perforation during Reinsertion of a Percutaneous Nephrostomy Catheter


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.


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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.
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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