Plastic Sheath Fragment Within Renal Pelvis: An Unusual and Rare Complication of Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is the treatment of choice for the management of large renal stones. This technique enjoys a high success rate with minimal complications being reported. We present a 54-year-old female who underwent a PCNL procedure on her right kidney and returned several months later with anxiety regarding vague left flank discomfort. Radiographic imaging done to assuage the patient's concerns surprisingly demonstrated a hyperdense curvilinear object in the interpolar calix of the right kidney. After an uneffective ureteroscopic extraction approach in the operating room, interventional radiology was consulted for foreign body extraction through a percutaneous access approach. This is the only known case in the literature to report a plastic sheath fragment as a foreign body in the renal collecting system after PCNL. We attempted to offer possible hypotheses for the source of this foreign body. The authors also emphasize the need for attentiveness during surgical procedures to monitor and identify integrity flaws that may exist in the instruments and ancillaries used.