A novel endoscopic treatment for renal arteriopelvic fistula post-percutaneous nephrolithotomy (PCNL)
Int. braz. j. urol
;
40(4): 568-573, Jul-Aug/2014. graf
Article
Dans Anglais
| LILACS
| ID: lil-723971
ABSTRACT
Main findings We describe the use of a novel endoscopic approach in the management of unremitting gross hematuria following post-percutaneous nephrolithotomy (PCNL) in a 65-years-old male. This approach proved successful and cost-effective in managing haemorrhage post-PCNL when renal angiography failed to localize the source of bleeding. Case hypothesis The recommended treatment modality for renal calculi ≥ 2cm is PCNL. It is essential that clinicians are aware of the various complications that can arise from PCNL, including arteriovenous fistula, which is typically managed with renal angio-embolization. The development of a renal arteriopelvic fistula (APF) is an extremely rare complication, and accounts of haemorrhage from renal APF and its treatment have not been well-described in the literature. We successfully hypothesized that the ureteroscopic localization, fulguration, and closure with a fibrin sealant at the site of the arterial bleed results in optimal treatment for this clinical presentation. We report this case in detail. Promising Future Implications The successful and cost-effective endoscopic approach described here for treatment of post-PCNL renal APF and unremitting gross hematuria ought to be considered as an adjunct to renal angiography and embolization when the source of bleeding cannot be accurately identified using traditional imaging modalities. .
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Complications postopératoires
/
Artère rénale
/
Néphrostomie percutanée
/
Fistule artérioveineuse
/
Urétéroscopie
/
Hématurie
Type d'étude:
Etude d'étiologie
/
Étude pronostique
Limites du sujet:
Adulte très âgé
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Int. braz. j. urol
Thème du journal:
Urologie
Année:
2014
Type:
Article
Pays d'affiliation:
Canada
Institution/Pays d'affiliation:
University of Calgary/CA
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