DẤN LƯU THẬN LẠC CHỖ VÀO TĨNH MẠCH CHỦ - MỘT BIẾN CHỨNG NẶNG VÀ HIẾM GẶP SAU TÁN SỎI THẬN QUA DA: BÁO CÁO CA LÂM SÀNG

Abstract

Intravenous misplacement of the nephrostomy catheter following percutaneous nephrostolithotomy (PCNL) is severe and extremely rare, and little information is available about this complication. Because the patient’s prognosis may be poor, sufficient attention should be paid to early identification and treatment of this complication. We report a case with intravenous nephrostomy catheter misplacement and active bleeding focis after PCNL in another hospital and was transferred to our hospital. The patient underwent vascular intervention to plug the pseudoaneurysms and arteriovenous fistula with coils and bio-glue. After that, the patient underwent renal vein – inferior vena cava angiography, renal sinus drainage and lesion node with surgicel. There were no severe complications. However, there is a small amount of thrombus attached to the vena cava wall but no anticoagulation was needed. During the withdrawal process, urological surgeon, cardiovascular surgeon, anesthesiologist, resuscitator and radiological intervention were involved. Before and after withdrawal, the patient was continously monitored at the Emergency – Intensive Care Department. Withdrawal could be performed by open surgery or under the supervision of imaging modalities. In which, the reports showed that drainage under supervision of imaging modalities was safer and less invasive than open surgery.