A case of fatal embolization during laser lithotripsy

Farì, Giorgia; Vecchio, Eleonora; Oliva, Antonio; Silvestri, Nicola; Dell’Aquila, Marco; Silvestri, Davide; Pennacchia, Ilaria; Arena, Vincenzo

doi:10.1007/s00414-021-02540-z

Cited by 1 publication

(1 citation statement)

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“…This low prevalence rate further highlights the unique presentation of the patient in our case study. The only case studies published associating PE with these procedures involved calcular PE resulting from renal stone fragments or gas entering into the venous circulation [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Peri-Ureteral Abscess Formation Following Ureteroscopic Laser Lithotripsy: A Case Report

Hammond¹,

Grekoski²,

Boukai³

et al. 2022

Cureus

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We report the case of a patient with a previous history of obstructive renal calculus disease who initially presented with a symptomatic calculus in her right mid-ureter, requiring ureteroscopy with laser lithotripsy and ureteral stent placement. Shortly after the removal of the stent, the patient was found to have a periureteral abscess, necessitating percutaneous drainage by interventional radiology, and placement of an additional ureteral stent. Adverse reactions to these procedures are rare and, to our knowledge, this is the only documented case of peri-ureteral abscess as a complication of ureteroscopic laser lithotripsy or of ureteral stenting. In addition to developing a peri-ureteral abscess, this patient also experienced deep vein thrombosis (DVT) and subsegmental pulmonary embolism (PE), which also have not been found to be a common complication of laser lithotripsy or ureteral stent placement in any of the studies that we reviewed for this article. The complications that were previously rare are unfortunately on the rise, possibly in the setting of both increased access to invasive therapies as well as the increased rates of diabetes and obesity. Survivability hinges on prompt recognition and treatment of these complications. In the event that a peri-ureteral abscess is discovered, prompt treatment with broad-spectrum antibiotics is recommended in addition to interventional radiology and urology consultation. Antibiotics should cover conventional intraabdominal and urologic abscess regimens.

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Section: Discussionmentioning

confidence: 99%