R. Ugalde-Resano , B. Montaño-Roca , G. Montiel-Ugalde, J.A. Varela-Prieto, D. Olvera-Posada, C.E. Méndez-Probst
{"title":"Trans-splenic puncture during percutaneous nephrolithotomy: Outcome spectrum of the same complication","authors":"R. Ugalde-Resano , B. Montaño-Roca , G. Montiel-Ugalde, J.A. Varela-Prieto, D. Olvera-Posada, C.E. Méndez-Probst","doi":"10.1016/j.uromx.2016.06.007","DOIUrl":null,"url":null,"abstract":"<div><p>Percutaneous nephrolithotomy is an endourologic technique commonly used in the management of nephrolithiasis. However, this procedure is not complication-free. Splenic injury is exceptionally rare with a reported rate of 1% from the total case load. We present herein two cases of splenic puncture during percutaneous nephrolithotomy that illustrate two different outcomes. In the first case, the patient remained asymptomatic and was discharged on her third post-operative day after removing the nephrostomy, without any sign of hemodynamic compromise. In the second case, the patient presented with hemodynamic instability and an abdominal computed tomography scan was done that showed free fluid in the peritoneal cavity. Emergency laparotomy was performed and revealed a deep peripheral laceration (20<!--> <!-->mm<!--> <!-->×<!--> <!-->5<!--> <!-->mm in length) that required splenectomy. After a thorough review of the existing literature, we could find only 11 other instances of injury to the spleen in which treatment outcomes were reported. Patient hemodynamic status was the main factor in deciding on the type of treatment.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2016.06.007","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista mexicana de urologia","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S200740851630043X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Percutaneous nephrolithotomy is an endourologic technique commonly used in the management of nephrolithiasis. However, this procedure is not complication-free. Splenic injury is exceptionally rare with a reported rate of 1% from the total case load. We present herein two cases of splenic puncture during percutaneous nephrolithotomy that illustrate two different outcomes. In the first case, the patient remained asymptomatic and was discharged on her third post-operative day after removing the nephrostomy, without any sign of hemodynamic compromise. In the second case, the patient presented with hemodynamic instability and an abdominal computed tomography scan was done that showed free fluid in the peritoneal cavity. Emergency laparotomy was performed and revealed a deep peripheral laceration (20 mm × 5 mm in length) that required splenectomy. After a thorough review of the existing literature, we could find only 11 other instances of injury to the spleen in which treatment outcomes were reported. Patient hemodynamic status was the main factor in deciding on the type of treatment.
期刊介绍:
Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.