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Published on: February 2, 2021
Delayed Post-percutaneous Nephrolithotomy Hemorrhage Managed With Superselective Renal Artery Embolization: A
Suryaram Aravind1, Punith Jain R2, Vivek Meyyappan1
1Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Percutaneous nephrolithotomy (PCNL) is the preferred treatment for large renal stones, though delayed arterial bleeding is a rare but serious complication. A 59-year-old male, previously discharged post-PCNL, presented on postoperative day 10 with gross hematuria and clot retention. CT angiography confirmed an interpolar segmental artery pseudoaneurysm. Superselective renal artery embolization (SSAE) with n-butyl cyanoacrylate achieved hemostasis without transfusion. Renal function was preserved, and the patient recovered uneventfully. The patient was reviewed after two weeks for follow-up after SSAE. This case illustrates the value of prompt vascular imaging in delayed post-PCNL bleeding and highlights the role of superselective renal artery angioembolization as a safe, effective, nephron-sparing intervention in modern endourological practice.
Percutaneous nephrolithotomy (PCNL) is the preferred treatment for large renal stones, though delayed arterial bleeding is a rare but serious complication. A 59-year-old male, previously discharged post-PCNL, presented on postoperative day 10 with gross hematuria and clot retention. CT angiography confirmed an interpolar segmental artery pseudoaneurysm. Superselective renal artery embolization (SSAE) with n-butyl cyanoacrylate achieved hemostasis without transfusion. Renal function was preserved, and the patient recovered uneventfully. The patient was reviewed after two weeks for follow-up after SSAE. This case illustrates the value of prompt vascular imaging in delayed post-PCNL bleeding and highlights the role of superselective renal artery angioembolization as a safe, effective, nephron-sparing intervention in modern endourological practice.
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