Nephropleural Fistula Effectively Managed with Serial Thoracentesis: A Case Report
Aaron D Baugh1, Eslam Youssef1, Syed Shafae Hasan1
1Department of Internal Medicine, University of Toledo College of Medicine , Toledo, Ohio.
Journal of Endourology Case Reports
|November 22, 2016
Summary
Nephropleural fistulae, a rare complication of percutaneous nephrolithotomy (PCNL), can be managed with serial thoracentesis. This less invasive approach offers a safe alternative to chest tube placement for select patients.
Area of Science:
- Thoracic surgery
- Nephrology
- Interventional radiology
Background:
- Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stones.
- Nephropleural fistulae are infrequent but severe thoracic complications following PCNL.
- Delayed presentation of nephropleural fistula requires effective management strategies.
Observation:
- A 54-year-old female patient presented with a delayed nephropleural fistula after PCNL.
- The case highlights the clinical course and diagnostic considerations for this rare complication.
- Conservative management options were evaluated for the patient's condition.
Findings:
- Serial thoracentesis was employed as a primary management strategy.
- This method proved to be a safe and less invasive alternative to traditional tube thoracostomy.
- Successful management of the nephropleural fistula was achieved without complications.
Implications:
- Serial thoracentesis may be an attractive option for managing select cases of nephropleural fistula post-PCNL.
- This approach offers potential benefits in terms of reduced pain and invasiveness.
- Further investigation into thoracentesis for nephropleural fistulae could refine treatment guidelines.
