Intrapleural t-PA therapy for loculated pleural effusion arising after percutaneous nephrolithotripsy: a case report

Pleural complications from upper pole percutaneous renal access for lithotripsy occur infrequently and are managed minimally invasively with urinary diversion (double-J stent or nephrostomy) and chest tube placement. However, sometimes the pleural effusion may evolve into an empyema that requires open or thoracoscopic decortication. We present a novel approach in which topical fibrinolytic therapy was used to successfully resolve a symptomatic, nonresolving (despite antibiotic treatment and a properly positioned chest tube), loculated pleural effusion arising post percutaneous nephrolithotripsy.