Renal Venous Perforation during Reinsertion of a Percutaneous Nephrostomy Catheter

Phil Hyun Song; Young Hwii Ko; Bong Gi Ok; Yeong Uk Kim; Kwon Soo Lee; Dae Hyeon Kwon; Hyun Tae Kim; Sin-Youl Park; Hee Chang Jung

doi:10.14777/kjutii.2014.9.1.56

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

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

Case Report

Korean J Urogenit Tract Infect Inflamm 2014;9(1):56-59.

Published online: 17 April 2014

DOI: https://doi.org/10.14777/kjutii.2014.9.1.56

Renal Venous Perforation during Reinsertion of a Percutaneous Nephrostomy Catheter

Phil Hyun Song, Young Hwii Ko, Bong Gi Ok, Yeong Uk Kim, Kwon Soo Lee, Dae Hyeon Kwon, Hyun Tae Kim¹, Sin-Youl Park², Hee Chang Jung

Department of Urology, Yeungnam University College of Medicine, Kyungpook National University, Daegu, Korea

¹Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea

²Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea

Correspondence to: Hee Chang Jung Department of Urology, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu 705-703, Korea Tel: +82-53-620-3691, Fax: +82-53-627-5535 E-mail: junghc@ynu.ac.kr

Received 31 December 20131 February 2014 Accepted 10 February 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Percutaneous nephrostomy, Renal veins, Phlebography

REFERENCES

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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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