Al-Kohlany Khaled M, Telha Khaled A, Al-Lahabi Noman, Almahmoud Hani M
Department of Urology, General Military Hospital and Medical College, Sana'a University, Sanaa, Yemen.
J Endourol Case Rep. 2017 Jun 1;3(1):70-73. doi: 10.1089/cren.2017.0025. eCollection 2017.
Colonic injury represents a rare complication of percutaneous nephrolithotomy (PCNL). Injury of the small bowel is very rare, with only anecdotal case reports in the literature. We report here a rare PCNL complication of jejunal perforation without concomitant colonic injury. A 45-year-old male underwent PCNL for multiple left kidney stones. At the beginning of the procedure, we faced difficulty in achieving access, but after that the procedure was straightforward and ended smoothly. However, from the third day, the postoperative course became stormy with progressive development of picture of acute peritonitis. Laparotomy was mandatory and jejunal perforation was found and repaired. Although extremely rare, small bowel injury should be kept in mind during planning for percutaneous nephrolithotomy. Prompt diagnosis and active treatment should be undertaken without delay especially if picture of acute peritonitis is developed.
结肠损伤是经皮肾镜取石术(PCNL)的一种罕见并发症。小肠损伤极为罕见,文献中仅有零星病例报告。我们在此报告一例罕见的经皮肾镜取石术并发空肠穿孔且无结肠损伤的病例。一名45岁男性因左肾多发结石接受经皮肾镜取石术。手术开始时,我们在建立通道方面遇到困难,但此后手术过程顺利,顺利结束。然而,术后第三天,病情突变,急性腹膜炎症状逐渐加重。必须进行剖腹手术,发现并修复了空肠穿孔。尽管极为罕见,但在计划经皮肾镜取石术时应考虑到小肠损伤。一旦出现急性腹膜炎症状,应立即进行及时诊断和积极治疗,不容延误。