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Published on: September 13, 2022
Splenic injury during percutaneous nephrolithotomy.
Anil A Thomas1, Gregory Pierce, R Matthew Walsh
1Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|August 8, 2009
Summary
Splenic injury during percutaneous nephrolithotomy can be managed nonoperatively. Using a collagen-thrombin hemostatic sealant offers a conservative approach for select patients, avoiding splenectomy.
Area of Science:
- Urology
- Surgical Complications
- Nephrolithotomy
Background:
- Percutaneous renal access carries a risk of splenic injury due to anatomical proximity.
- Transsplenic renal access during percutaneous nephrolithotomy is a rare but serious complication, potentially necessitating splenectomy.
Observation:
- A case of splenic injury during percutaneous nephrolithotomy is presented.
- Management involved conservative treatment with a collagen-thrombin hemostatic sealant.
- Delayed nephrostomy tube removal was performed post-sealant application.
Findings:
- The patient experienced an uneventful recovery.
- Discharge occurred on postoperative day 6, indicating successful conservative management.
Implications:
- Nonoperative management is a viable option for hemodynamically stable patients with splenic injury during percutaneous nephrolithotomy.
- Adjunctive hemostatic sealants can facilitate successful conservative treatment, potentially preventing splenectomy.
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