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经皮肾镜取石术后持续性肾胸膜瘘1例罕见病例。

A rare case of persistent nephropleural fistula following percutaneous nephrolithotomy.

作者信息

Bansal Devanshu, Nayak Brusabhanu, Singh Prabhjot, Srivastava Prashant

机构信息

Department of Urology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

BMJ Case Rep. 2017 Jul 27;2017:bcr-2017-220466. doi: 10.1136/bcr-2017-220466.

Abstract

Nephropleural fistula following percutaneous nephrolithotomy (PCNL) is a very rare complication and there are only a few case reports available in the literature. We present a case of a 65-year-old male patient with a right staghorn renal calculus and a left upper ureteric calculus who developed a right nephropleural fistula following right-sided PCNL. The patient required intercostal tube drainage. The cause of the fistula was identified to be a superior calyceal infundibular obstruction due to tiny residual stone fragments and oedema, which was endoscopically dilated, and the fistula subsequently healed. Urinary diversion using chest drainage and percutaneous nephrostomy followed by infundibular dilation and removal of secondary stones allowed the successful closure of the nephropleural fistula in our case.

摘要

经皮肾镜取石术(PCNL)后发生肾胸膜瘘是一种非常罕见的并发症,文献中仅有少数病例报告。我们报告一例65岁男性患者,患有右鹿角形肾结石和左输尿管上段结石,在右侧PCNL后发生了右肾胸膜瘘。患者需要肋间置管引流。瘘管的原因被确定为微小残留结石碎片和水肿导致的上肾盏漏斗部梗阻,通过内镜扩张后,瘘管随后愈合。在我们的病例中,采用胸腔引流和经皮肾造瘘进行尿液改道,随后进行漏斗部扩张和取出继发结石,成功闭合了肾胸膜瘘。

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