Life-threatening biliary complications after percutaneous nephro-lithotomy: a case report

Area of Science:

• Urology
• Gastroenterology
• Surgical Complications

Background:

• Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone management.
• While generally safe, PCNL carries a risk of rare but severe complications.
• This report focuses on an unusual complication involving the biliary system.

Observation:

• A 55-year-old woman developed severe bleeding requiring emergency nephrectomy post-PCNL.
• One week later, she presented with acute abdomen and biliary peritonitis.
• Necrosis of the common bile duct and duodenal perforation were identified as the cause.

Findings:

• The patient experienced life-threatening extrahepatic biliary tree necrosis and duodenal perforation.
• Surgical intervention included external biliary diversion, duodenal exclusion, and gastrojejunal anastomosis.
• The case underscores the potential for severe, unexpected sequelae of PCNL.

Implications:

• This case emphasizes the importance of vigilance for rare complications after PCNL.
• Understanding and discussing putative risk factors may improve patient safety.
• Further research into preventing such severe biliary complications is warranted.