Jejunal Injury as a Rare Complication of Percutaneous Nephrolithotomy: Case Report

Alkohlany, Khaled; Telha, Khaled; Al-Lahabi, Noman; Almahmoud, Hani M

doi:10.1089/cren.2017.0025

Cited by 3 publications

(6 citation statements)

References 4 publications

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“…However, delay of a necessary surgical approach can increase risk of contamination, septicemia, and death. Criteria related to the mechanism of the lesion, affected side, and role of the CT [5] intraop (pyelography) -Transfixation Conservative Begliomini et al [6] 1d Peritonitis Transfixation Laparotomy Kumar et al [7] intraop (nephroscopy) -Perforation Conservative Ahmed and Reeve [8] intraop (nephroscopy) -Perforation Conservative Santiago et al [9] 2d Abdominal pain Transfixation Laparotomy Culkin et al [10] 3d Localized pain Perforation Conservative Saad et al [11] 1d Peritonitis Transfixation Laparotomy Viville et al [12] 2d ND a ND Laparotomy Winer et al [13] 5d…”

Section: Discussionmentioning

confidence: 99%

“…Apart from the case analyzed herein (case 11, Tables 1, 2), 18 articles were part of this study, with 10 of them being case reports [7][8][9][10][11][12][13][14][15][16].…”

Section: Methodsmentioning

confidence: 99%

“…The colon is the most commonly affected intestinal segment, representing about 0.2-0.8% [6] of complications. On the other hand, small bowel lesions are rare, with few cases reported in the literature [7][8][9][10][11][12][13][14][15][16]. Infectious complications related to intestinal perforation can be fatal if not diagnosed and treated accordingly [17].…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and management of small intestinal injury due to percutaneous renal access

et al. 2021

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Purpose Define factors for proper diagnosis and treatment of small intestinal injury during procedures with percutaneous renal access, thus optimizing favorable outcomes and avoiding complications and death during conservative or surgical approaches. Materials and methods Bibliographic review of case reports available in the literature and presentation of data from an additional case have been carried out. Results Percutaneous nephrolithotripsy was the procedure that most frequently caused injury of the small intestine. Time for diagnosis of the lesion took up to 5 days after the intraoperative phase. When occurring in the intraoperative phase, perforation was identified by direct endoscopic visualization; a catheter was then placed inside the intestinal lumen and a conservative approach to the derived fistula was adopted, which led to successful outcomes in all cases. Abdominal pain was the most common symptom in cases diagnosed during the postoperative phase (75%). In the presence of signs of peritonitis, surgical intervention was performed, with favorable evolution in all cases. Conclusions Conservative management of small intestine injuries is possible when there is no peritoneal contamination. Its success factors include intraoperative diagnosis and non-transfixing lesions, which is more common in duodenal involvement. Laparotomy to clean the cavity associated with a corrective approach (enterorrhaphy or enterectomy with primary anastomosis) was successfully indicated in cases of late diagnosis with signs of peritonitis, a situation that is most commonly found in transfixing lesions of ileum and jejunum.

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Section: Discussionmentioning

confidence: 99%

“…Apart from the case analyzed herein (case 11, Tables 1, 2), 18 articles were part of this study, with 10 of them being case reports [7][8][9][10][11][12][13][14][15][16].…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis and management of small intestinal injury due to percutaneous renal access

et al. 2021

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“…In our case, a needle over advancement probably took place and this complication could be detected at the end of the manipulation by X-ray control if we injected more contrast through the catheter, but fear to exacerbate the infectious process precluded us from doing so. Management of a duodenal injury associated with percutaneous kidney access gaining was well described so far and ranged from surgical options including laparotomy to conservative, with prolonged fasting up to 14 days, parenteral hyperalimentation, and prolonged hospital stay [5, 6]. Despite the fact that the location of the duodenal defect directed our surgical team towards open surgery experience of our endoscopist, who is managing duodenal adenocarcinoma endoscopically [7] and the size of the defect was taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy

Gadzhiev

Gorelov

Смирнов

et al. 2018

Case Reports in Urology

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Background. Gaining percutaneous access during percutaneous nephrolithotomy (PNL) can be complicated with the bowel injury. We report a novel approach of management of duodenal injury complicating percutaneous drainage of infected haematoma after Shock-Wave Lithotripsy (SWL). Case Presentation. A 57-year-old patient with the 15 mm right pelvic kidney stone underwent uneventful SWL. Patient visited emergency department 3 days later with high fever and chills with severe right flank pain. CT urography revealed lower pole kidney injury with signs of infected hematoma due to low attenuation areas but without signs of obstruction or urine leakage. Infected haematoma was drained percutaneously under ultrasound and X-ray control and a pigtail catheter 10 Fr was left beneath the lower pole of the right kidney. Postoperatively duodenal injury was suspected due to amber color, low creatinine, and high bilirubin level in the drainage output. CT demonstrated that the pigtail of the drain had entered the second part of the duodenum. Catheter was withdrawn and defect of the duodenal wall was stapled with four staples endoscopically. After 2 days of fasting patient was allowed to start oral food intake and was discharged on the 5th day. Conclusion. Injury of the duodenum during percutaneous kidney manipulation is an extremely rare complication. Conservative management consisting of endoscopic stapling of the duodenal wall defect is a safe and feasible approach to expediting the recovery of the patient.

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“…If left untreated, perforation may be complicated by renal abscess, fistula, and peritonitis [2] , [3] . Owing to the mismatch between the small-bowel position and the path for renal tract dilatation during PCNL, small-bowel perforation is very rare, with only isolated reports of jejunal and ileal injuries in the literature [4] , [5] , [6] .…”

Section: Introductionmentioning

confidence: 99%

Bowel Perforation During Percutaneous Nephrolithotomy: Diagnosis, Management, and Follow-up

Savin,

Nevo,

Sofer

2024

European Urology Open Science

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Jejunal Injury as a Rare Complication of Percutaneous Nephrolithotomy: Case Report

Cited by 3 publications

References 4 publications

Diagnosis and management of small intestinal injury due to percutaneous renal access

Diagnosis and management of small intestinal injury due to percutaneous renal access

Novel Approach for Endoscopic Management of Duodenal Injury during Perirenal Infected Haematoma Drainage after Shock-Wave Lithotripsy

Bowel Perforation During Percutaneous Nephrolithotomy: Diagnosis, Management, and Follow-up

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