Gu Zhuoran, Ma Tantu, Zhang Wentao, Jiang Lei, Yao Xudong, Chen Yifan
Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China.
Urologic Cancer Institute, School of Medicine, Tongji University, Shanghai, China.
Urol Case Rep. 2025 Apr 16;60:103044. doi: 10.1016/j.eucr.2025.103044. eCollection 2025 May.
A 50-year-old female with left flank pain and 3.1 cm renal calculi underwent PCNL. Intraoperatively, an anatomical variant led to accidental insertion of a nephrostomy tube into the inferior vena cava (IVC), while a second tube was correctly placed. Postoperative edema prompted CT imaging revealing the malposition. The misplaced tube was incrementally withdrawn under CT guidance over days to prevent bleeding complications, then repositioned successfully. Three-month follow-up confirmed resolution of hydronephrosis, absence of strictures or bleeding, and complete wound healing. This case underscores the necessity of intraoperative anatomical vigilance and staged management of iatrogenic vascular injuries during PCNL.
一名50岁左侧腰痛且患有3.1厘米肾结石的女性接受了经皮肾镜取石术（PCNL）。术中，一个解剖变异导致肾造瘘管意外插入下腔静脉（IVC），而另一根管子放置正确。术后水肿促使进行CT成像，显示出管子位置不当。在数天内，在CT引导下逐步拔出位置不当的管子以防止出血并发症，然后成功重新定位。三个月的随访证实肾积水消退、无狭窄或出血且伤口完全愈合。该病例强调了PCNL术中对解剖结构保持警惕以及对医源性血管损伤进行分阶段处理的必要性。
