Colon perforation following percutaneous nephrostomy and renal calculus removal.

LeRoy, Andrew J.; Williams, Harold L.; Bender, Claire E.; Segura, Joseph W.; Patterson, D E; Benson, Ralph C.

doi:10.1148/radiology.155.1.3975424

Cited by 90 publications

(30 citation statements)

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“…A retrorenal colon is more frequently found on the left side and is most likely to be situated near the inferior kidney pole. (11) Retrorenal colon is found in approximatively 0.6% of the general population according to the Hadar-Gadot and Sherman et al study. (12,13) In another study with 333 participants, CT images showed that the left colon was posterior in 16.1% of cases, and the right colon was posterior in 9% of cases at the level of the lower pole.…”

Section: Resultsmentioning

confidence: 94%

Percutaneous Nephrolithotomy and Retrorenal Colon: Its Incidence and Complications

S¹,

Shaik²

2015

jemds

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OBJECTIVE:The aim of this study was to investigate retrorenal colon incidence in percutaneous nephrolithotomy (PCNL) and to discuss the necessity of routine preoperative CT and perform a cost analysis of this procedure. MATERIALS AND METHODS: Clinical data of 608 PCNL patients over a 5 year period (2008)(2009)(2010)(2011)(2012)(2013), was surveyed. The patient files were reviewed retrospectively, and only those who had abdominal computed tomography (CT) images before PCNL intervention were included in the study. In the CT images, the position of both the ascending and descending colon in relation to the right and left kidneys were evaluated. We compared the total cost of CTs per incidence of retro colon versus the cost of restoring complications. RESULTS: According to our hospital reports, 262 patients with CT images were included in the present study. 4 patients (1.14%) had retrorenal colon, of which 2(0.76%) were on the left side, 1(0.38%) on the right side and 1(0.38%) had bilateral retrorenal colons. Colonic perforation complication was seen only in two patients who had no CT images and the colonic perforation rate was 0.57%. The cost of recognizing one retrorenal colon case using CT was cost-effective to avoid a serious complication. CONCLUSIONS: PCNL, in the process of becoming the standard treatment modality, is a safe and reliable technique for renal stone treatment. Colonic injury should be taken into consideration during PCNL interventions of the lower pole of the kidney. CT, which should be low-dose, if possible, should be performed routinely in all patients to prevent colon injuries. This technique appears to be cost-effective.

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Section: Resultsmentioning

confidence: 94%

Percutaneous Nephrolithotomy and Retrorenal Colon: Its Incidence and Complications

S¹,

Shaik²

2015

jemds

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“…We suggested that the use of preoperative computed tomography and the more posterior site of skin puncture (at the posterior axillary line) decrease the incidence of colonic injury. Both LeRoy et al (17) and Hopper et al (18) found that only 2% of their patients had retro renal colon when supine which subsequently increased to 10% when prone. Valdivia et al (5) reported that the colon was more distant from the kidney in the supine position in comparison to the prone position after performing renal puncture in the supine position in human corpses.…”

Section: Discussionmentioning

confidence: 94%

When prone position is contraindicated or not preferable, can supine percutaneous nephrolithotomy solve the problem?

2012

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“…T h e rarity of this anatomical arrangement is confirmed by the infrequency with which the bowel is punctured during posterior percutaneous procedures (Bonaldi et al, 1991;LeRoy et al, 1985) and by the work of Helms et a]. (1989), who reviewed prone CT studies in 346 patients before percutaneous diskectomy.…”

Section: Discussionmentioning

confidence: 98%

“…In recent years this variation has attracted attention because of increasing interest in percutaneous renal (Reznek and Talner, 1984) and vertebral (Bonaldi et al, 1991) procedures. A posteriorly situated colon may be damaged if too posterolateral an approach is used (LeRoy et al, 1985). Hence there have been numerous articles detailing the position of the colon, as shown by CT; these have particularly considered the position in relation to the kidneys (Hadar and Gadoth, 1984;Sherman et al, 1985;Hopper et al, 1987;Helms et al, 1989;Prassopoulos et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

Posteriorly situated retroperitoneal colon: A study using CT and MRI

et al. 1993

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In a patient with symptoms attributable to lumbar spine disease, computed tomography (CT) demonstrated the descending colon lying in an exceptionally posteromedial position. The colon, within the retroperitoneal fat, passed between the psoas major and quadratus lumborum muscles, thereby abutting the normal left L4 ventral ramus lateral to the L5 pedicle. Although it remains debatable whether this curious anatomical arrangement was responsible for this patient's symptoms, the case prompted us to see how often the colon was situated so posteromedially. Among 33 consecutive patients whose abdominal CT images were analyzed, this close anatomical relationship was seen in only one patient; it was not seen in any of 50 randomly selected patients undergoing magnetic resonance imaging (MRI) of the lumbar spine. As judged by CT measurements, the average position of the most posteromedial portion of the descending colon lies 5 mm anterolateral to a plane joining the anterolateral margins of the psoas major, quadratus lumborum, and iliacus muscles and 54 mm from the ventral ramus. 0 1993 Wiley-Liss, Inc.

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Colon perforation following percutaneous nephrostomy and renal calculus removal.

Cited by 90 publications

References 0 publications

Percutaneous Nephrolithotomy and Retrorenal Colon: Its Incidence and Complications

Percutaneous Nephrolithotomy and Retrorenal Colon: Its Incidence and Complications

When prone position is contraindicated or not preferable, can supine percutaneous nephrolithotomy solve the problem?

Posteriorly situated retroperitoneal colon: A study using CT and MRI

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