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双J输尿管支架管腔静脉内误置

Intracaval misplacement of a double-J ureteral stent.

作者信息

Marques Vera, Parada Belmiro, Rolo Francisco, Figueiredo Arnaldo

机构信息

Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.

Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal.

出版信息

BMJ Case Rep. 2018 Feb 8;2018:bcr-2017-221713. doi: 10.1136/bcr-2017-221713.

Abstract

Double-J ureteral stent (DJUS) is an important therapeutic tool in endourology. There are well-known frequent complications associated with DJUS placement such as distal and proximal migration within the urinary tract. However, perforation and stent misplacement are uncommon but serious complications of this technique. We present a case of a 63-year-old man who had a misplacement of a DJUS into the inferior vena cava during an elective procedure of ureteral catheterisation. The stent placement was performed under fluoroscopic control and it seemed well positioned. Actually, the DJUS was misplaced in the inferior vena cava after drilling at the level of the crossing of the ureter with the ipsilateral iliac vessels. Diagnosis was incidentally made 3 months after the placement of the stent in a renal CT scan. The patient was always asymptomatic. We performed an endoscopic removal of the ureteral stent, which took place without complications.

摘要

双J输尿管支架(DJUS)是腔内泌尿外科的一种重要治疗工具。DJUS置入存在一些众所周知的常见并发症,如在泌尿道内的远端和近端移位。然而,穿孔和支架误置是该技术少见但严重的并发症。我们报告一例63岁男性患者,在输尿管插管择期手术期间DJUS误置入下腔静脉。支架置入在荧光镜控制下进行,当时看起来位置良好。实际上,在输尿管与同侧髂血管交叉处钻孔后,DJUS误置于下腔静脉。支架置入3个月后,在肾脏CT扫描中偶然发现诊断。患者一直无症状。我们通过内镜取出输尿管支架,手术过程无并发症。

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