Akatsuka Jun, Suzuki Yasutomo, Endo Yuki, Yanagi Masato, Matsuzawa Ichiro, Hamasaki Tsutomu, Kimura Go, Kondo Yukihiro
Department of Urology Nippon Medical School Tokyo Japan.
IJU Case Rep. 2021 Mar 11;4(3):168-171. doi: 10.1002/iju5.12276. eCollection 2021 May.
We encountered an extremely rare case of a nephrostomy catheter entering the right renal vein during an exchange procedure.
An 80-year-old man underwent radical cystectomy. Urinary diversion was achieved through right percutaneous nephrostomy. After the 15 nephrostomy catheter exchange, the patient bled heavily from the catheter. We clamped the catheter immediately, and the patient became hemodynamically stable. Emergency angiography showed the nephrostomy catheter entering the renal vein from outside the renal pelvis. Under fluoroscopy, we pulled the catheter until its tip was located in the previous penetration site of the renal pelvic wall and inserted the catheter over the guidewire into the renal pelvis.
Herein, we report an extremely rare case of a nephrostomy catheter inserted into the right renal vein during an exchange procedure. Inserting a nephrostomy catheter in the appropriate position and performing exchange under imaging guidance techniques could help clinicians avoid severe complications.
我们遇到了一例极为罕见的病例,在更换肾造瘘导管的过程中,导管进入了右肾静脉。
一名80岁男性接受了根治性膀胱切除术。通过右经皮肾造瘘实现尿液改道。在第15次更换肾造瘘导管后,患者通过导管大量出血。我们立即夹住导管,患者血流动力学变得稳定。急诊血管造影显示肾造瘘导管从肾盂外进入肾静脉。在荧光透视下,我们将导管拉出,直到其尖端位于肾盂壁先前的穿刺部位,然后通过导丝将导管插入肾盂。
在此,我们报告了一例在更换导管过程中肾造瘘导管插入右肾静脉的极为罕见的病例。在合适的位置插入肾造瘘导管并在影像引导技术下进行更换,有助于临床医生避免严重并发症。