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[Colonic perforations during interventional urinary radiology].

P J Maillet, J P Dulac, X Barth

    Journal De Radiologie
    |March 1, 1986
    PubMed
    Summary
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    Percutaneous nephrostomy and lithotripsy can cause colonic perforation, requiring surgery. Computed tomography (CT) is recommended for visualizing colon position during kidney access procedures.

    Area of Science:

    • Urology
    • Gastroenterology
    • Radiology

    Background:

    • Percutaneous nephrostomy and lithotripsy are common procedures for kidney stone management.
    • Colonic perforation is a rare but serious complication associated with these interventions.

    Observation:

    • Three patients experienced colonic perforation following percutaneous nephrostomy and lithotripsy.
    • Conservative management failed in these cases, necessitating surgical intervention including colostomy, hemicolectomy, and drainage.

    Findings:

    • Fluoroscopy and ultrasonography provide insufficient accuracy for determining colon proximity during percutaneous renal access.
    • Computed tomography (CT) is identified as the preferred imaging modality for precise anatomical assessment.
    • Risk factors for colonic injury include patient characteristics (thin, young, female), a dilated pelvo-calyceal system, and concurrent colonic obstruction.

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    Implications:

    • Enhanced awareness of anatomical relationships and improved imaging techniques are crucial for preventing colonic injury.
    • CT imaging should be considered for pre-procedural planning in high-risk patients undergoing percutaneous renal procedures.
    • Minimizing iatrogenic injury during percutaneous nephrostomy and lithotripsy is essential for patient safety and outcomes.