输尿管单 J 支架移位至心脏:病例报告和文献综述

Y. Boukhlifi, Anouar Ghazzaly, Mohammed Tetou, Larbi Hamedoun, Karim Blelhaj, M. Mrabti, Abdessamad Elbahri, N. Louardi, Mohammed Alami, Ahmed Ameur
{"title":"输尿管单 J 支架移位至心脏:病例报告和文献综述","authors":"Y. Boukhlifi, Anouar Ghazzaly, Mohammed Tetou, Larbi Hamedoun, Karim Blelhaj, M. Mrabti, Abdessamad Elbahri, N. Louardi, Mohammed Alami, Ahmed Ameur","doi":"10.36347/sjmcr.2024.v12i02.006","DOIUrl":null,"url":null,"abstract":"The placement of urethral stents is a commonly performed procedure in urology, typically without complications. However, as illustrated in the present case, major complications can arise. It is crucial to be vigilant about the risk of intravascular or intracardiac malpositioning of the ureteral device, especially when there is an unfavorable evolution or the presence of hematuria. We present the case of a 68-year-old patient undergoing treatment for locally advanced cervical cancer with concomitant radiotherapy and chemotherapy. In the course of her follow-up, the patient developed obstructive renal failure due to extrinsic compression of the ureters. Despite attempts with JJ stent placement, emergency renal drainage became necessary, leading to bilateral nephrostomy. In order to alleviate the patient from nephrostomy tubes and enhance her quality of life, bilateral direct cutaneous ureterostomy was performed, with Single-J probes placed in both ureters. However, during the 4th tube change, conducted without scopic control, the patient experienced thoracic and low back pain at 8 days post-operatively. The CT scan revealed that the left Single-J probe bypassed the renal pelvis without penetrating it. Instead, it ascended the IVC, entering the right atrium, and subsequently reached the right ventricle, accompanied by left pyelocaliectasis. The resolution of the issue was achieved through the implementation of a multidisciplinary approach, engaging the expertise of both urologists and vascular surgeons. The removal procedure involved extracting the distal end of the catheter using a ureteroscope, with simultaneous collaboration from the vascular surgery team. The vascular surgeons performed femoral access and phlebography both during and after catheter removal to mitigate the risk of potential bleeding from the inferior vena cava (IVC). Abdominal access for laparotomy was prepared in anticipation of potential bleeding.\" The patient underwent placement of a left Single-","PeriodicalId":509943,"journal":{"name":"Scholars Journal of Medical Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Displacement of a Ureteral Single J Stent into the Heart: A Case Report and Literature Review\",\"authors\":\"Y. Boukhlifi, Anouar Ghazzaly, Mohammed Tetou, Larbi Hamedoun, Karim Blelhaj, M. Mrabti, Abdessamad Elbahri, N. Louardi, Mohammed Alami, Ahmed Ameur\",\"doi\":\"10.36347/sjmcr.2024.v12i02.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The placement of urethral stents is a commonly performed procedure in urology, typically without complications. However, as illustrated in the present case, major complications can arise. It is crucial to be vigilant about the risk of intravascular or intracardiac malpositioning of the ureteral device, especially when there is an unfavorable evolution or the presence of hematuria. We present the case of a 68-year-old patient undergoing treatment for locally advanced cervical cancer with concomitant radiotherapy and chemotherapy. In the course of her follow-up, the patient developed obstructive renal failure due to extrinsic compression of the ureters. Despite attempts with JJ stent placement, emergency renal drainage became necessary, leading to bilateral nephrostomy. In order to alleviate the patient from nephrostomy tubes and enhance her quality of life, bilateral direct cutaneous ureterostomy was performed, with Single-J probes placed in both ureters. However, during the 4th tube change, conducted without scopic control, the patient experienced thoracic and low back pain at 8 days post-operatively. The CT scan revealed that the left Single-J probe bypassed the renal pelvis without penetrating it. Instead, it ascended the IVC, entering the right atrium, and subsequently reached the right ventricle, accompanied by left pyelocaliectasis. The resolution of the issue was achieved through the implementation of a multidisciplinary approach, engaging the expertise of both urologists and vascular surgeons. The removal procedure involved extracting the distal end of the catheter using a ureteroscope, with simultaneous collaboration from the vascular surgery team. The vascular surgeons performed femoral access and phlebography both during and after catheter removal to mitigate the risk of potential bleeding from the inferior vena cava (IVC). Abdominal access for laparotomy was prepared in anticipation of potential bleeding.\\\" The patient underwent placement of a left Single-\",\"PeriodicalId\":509943,\"journal\":{\"name\":\"Scholars Journal of Medical Case Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scholars Journal of Medical Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36347/sjmcr.2024.v12i02.006\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scholars Journal of Medical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36347/sjmcr.2024.v12i02.006","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

放置尿道支架是泌尿外科常用的手术,通常不会出现并发症。然而,正如本病例所示,也可能出现重大并发症。必须警惕输尿管装置在血管内或心脏内错位的风险,尤其是在病情发展不利或出现血尿的情况下。我们报告了一例 68 岁患者的病例,该患者接受了局部晚期宫颈癌治疗,并同时接受了放疗和化疗。在随访过程中,由于输尿管受到外来压迫,患者出现了梗阻性肾衰竭。尽管尝试了 JJ 支架置入术,但仍需进行紧急肾引流,导致双侧肾造口术。为了让患者摆脱肾造瘘管的束缚,提高其生活质量,医生为其实施了双侧直接经皮输尿管造口术,并在双侧输尿管中均放置了 Single-J 探头。然而,在术后第 4 次换管时,由于没有进行镜下控制,患者在术后 8 天出现胸痛和腰痛。CT 扫描显示,左侧 Single-J 探头绕过肾盂,但未穿透肾盂。相反,它上升到 IVC,进入右心房,随后到达右心室,并伴有左肾盂局部扩张。泌尿科医生和血管外科医生采用多学科方法解决了这一问题。移除过程包括使用输尿管镜拔出导尿管远端,血管外科团队也同时协作。血管外科医生在导管拔除过程中和拔除后都进行了股动脉通路和静脉造影,以降低下腔静脉(IVC)潜在的出血风险。由于预计到可能发生出血,因此准备了开腹手术的腹部入路"。患者接受了左侧单腔静脉导管置入术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Displacement of a Ureteral Single J Stent into the Heart: A Case Report and Literature Review
The placement of urethral stents is a commonly performed procedure in urology, typically without complications. However, as illustrated in the present case, major complications can arise. It is crucial to be vigilant about the risk of intravascular or intracardiac malpositioning of the ureteral device, especially when there is an unfavorable evolution or the presence of hematuria. We present the case of a 68-year-old patient undergoing treatment for locally advanced cervical cancer with concomitant radiotherapy and chemotherapy. In the course of her follow-up, the patient developed obstructive renal failure due to extrinsic compression of the ureters. Despite attempts with JJ stent placement, emergency renal drainage became necessary, leading to bilateral nephrostomy. In order to alleviate the patient from nephrostomy tubes and enhance her quality of life, bilateral direct cutaneous ureterostomy was performed, with Single-J probes placed in both ureters. However, during the 4th tube change, conducted without scopic control, the patient experienced thoracic and low back pain at 8 days post-operatively. The CT scan revealed that the left Single-J probe bypassed the renal pelvis without penetrating it. Instead, it ascended the IVC, entering the right atrium, and subsequently reached the right ventricle, accompanied by left pyelocaliectasis. The resolution of the issue was achieved through the implementation of a multidisciplinary approach, engaging the expertise of both urologists and vascular surgeons. The removal procedure involved extracting the distal end of the catheter using a ureteroscope, with simultaneous collaboration from the vascular surgery team. The vascular surgeons performed femoral access and phlebography both during and after catheter removal to mitigate the risk of potential bleeding from the inferior vena cava (IVC). Abdominal access for laparotomy was prepared in anticipation of potential bleeding." The patient underwent placement of a left Single-
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信