Batura Deepak, Haylock-Vize Patricia, Naji Yaser, Tennant Rachel, Fawcett Katherine
Department of Urology, Northwick Park Hospital, London, UK.
Department of Interventional Radiology, Northwick Park Hospital, London, UK.
J Radiol Case Rep. 2014 Jan 1;8(1):34-40. doi: 10.3941/jrcr.v8i1.1424. eCollection 2014 Jan.
A 64 year-old male with metastatic prostate adenocarcinoma presented with bilateral hydronephrosis and renal impairment. Bilateral percutaneous nephrostomy drainage followed by ante-grade stenting was done. Shortly afterwards, the patient developed an extensive left-sided pleural effusion. His serum creatinine rose and he became anuric. Emergency pleural aspiration and later, pleural drainage were performed. Pleural aspirate was diagnostic of urinothorax and non contrast CT scan demonstrated a left reno-pleural fistula. The right stent was removed cystoscopically. The left stent could not be removed cystoscopically and was replaced in an ante grade manner through a fresh percutaneous renal approach. This led to cessation of pleural fluid accumulation. The patient was discharged with bilateral ureteric stents and normal renal function. A month later, he had normal renal function, no hydronephrosis and normal chest x-rays.
一名64岁患有转移性前列腺腺癌的男性患者出现双侧肾积水和肾功能损害。先行双侧经皮肾造瘘引流，随后进行顺行支架置入。不久后，患者出现大量左侧胸腔积液。他的血清肌酐升高，并且无尿。进行了紧急胸腔穿刺抽吸，随后进行胸腔引流。胸腔穿刺液诊断为尿胸，非增强CT扫描显示左肾胸膜瘘。经膀胱镜取出右侧支架。经膀胱镜无法取出左侧支架，遂通过新的经皮肾途径顺行更换支架。这导致胸腔积液停止积聚。患者带着双侧输尿管支架出院，肾功能正常。一个月后，他肾功能正常，无肾积水，胸部X光片正常。
