Liu Qian, Yang Chuan, Lin Kai, Yang Dong
Tumor and Interventional Radiology, Hanchuan People's Hospital, Hanchuan 432300, Hubei Province, China.
Urology, Hanchuan People's Hospital, Hanchuan 432300, Hubei Province, China.
World J Clin Cases. 2020 Nov 26;8(22):5790-5794. doi: 10.12998/wjcc.v8.i22.5790.
Lumbar artery bleeding is an uncommon complication of percutaneous nephrolithotomy (PCNL). This report presents a rare complication where two lumbar arteries were injured by a single puncture following PCNL. Only scarce reports of this complication have been reported.
A 24-year-old man presented with a 2.2 cm right renal calculus, which was managed by PCNL. During nephrostomy tube removal on the 6 postoperative day, intense bleeding was observed in the fistula and the catheter. Renal angiography was undertaken immediately; however, an initial selective renal angiogram revealed no evidence of renal vascular injury. One of these injuries involved a pseudoaneurysm from a peripheral branch in the first right lumbar artery, while the other involved an arteriovenous fistula from a peripheral branch in the second right lumbar artery. Subsequently, coil embolization was performed successfully.
This case is being reported to inform clinicians that lumbar artery damage is one of the causes of severe bleeding after PCNL and could involve damage of more than one artery.
腰动脉出血是经皮肾镜取石术（PCNL）一种罕见的并发症。本报告呈现了PCNL术后单次穿刺损伤两条腰动脉这一罕见并发症。关于该并发症仅有极少的报道。
一名24岁男性，患有2.2厘米的右肾结石，接受了PCNL治疗。术后第6天拔除肾造瘘管时，在瘘管和导管处观察到大量出血。立即进行了肾血管造影；然而，最初的选择性肾血管造影未显示肾血管损伤的迹象。其中一处损伤是右第一腰动脉外周分支形成假性动脉瘤，另一处损伤是右第二腰动脉外周分支形成动静脉瘘。随后，成功进行了弹簧圈栓塞术。
报告该病例是为了告知临床医生，腰动脉损伤是PCNL术后严重出血的原因之一，且可能涉及多条动脉损伤。
