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Delayed Nephropleural Fistula After Percutaneous Nephrolithotomy
Kamaljot S Kaler1, Daniel Cwikla1, Ralph V Clayman1
1Department of Urology, University of California , Irvine, Orange, California.
Journal of Endourology Case Reports
|September 1, 2016
Summary
Delayed nephropleural fistula after percutaneous nephrolithotomy (PCNL) is rare. This case highlights a delayed presentation of a nephropleural fistula, emphasizing the need for vigilance in patients experiencing delayed symptoms post-PCNL.
Area of Science:
- Urology
- Nephrology
- Thoracic Surgery
Background:
- Supracostal percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stones.
- Pleural effusions are a known complication of supracostal PCNL, typically diagnosed early postoperatively.
Observation:
- A 52-year-old female presented with delayed symptoms 8 days after a supracostal PCNL.
- Symptoms included right pleural effusion, contralateral renal colic, and acute renal failure.
Findings:
- The patient was diagnosed with a delayed nephropleural fistula.
- This rare complication occurred after an initially uneventful PCNL procedure.
Implications:
- This case underscores the importance of considering delayed nephropleural fistula in patients with unexplained delayed symptoms after PCNL.
- Prompt diagnosis and management, including chest tube drainage and nephrostomy tubes, are crucial for favorable outcomes.
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