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Air Pyelogram for Percutaneous Nephrolithotomy in Patients with Iodinated Contrast-induced Anaphylaxis
Suraj Bhondave1, Racheruvu Siddhartha
1Department Of Urology, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India.
Annals of African Medicine
|April 28, 2026
Summary
Air pyelography offers a safe alternative to contrast media for patients undergoing percutaneous nephrolithotomy (PCNL). This technique successfully delineated the renal collecting system, enabling safe access during PCNL in cases of contrast allergy.
Area of Science:
- Urology
- Nephrology
- Radiology
Background:
- Percutaneous nephrolithotomy (PCNL) is a primary treatment for large kidney stones.
- Iodinated contrast agents used for fluoroscopic guidance in PCNL can cause anaphylaxis in susceptible patients.
Purpose of the Study:
- To evaluate the efficacy of air pyelography as a contrast-free method for renal access during PCNL.
- To present successful cases of air pyelography in patients with contrast allergy.
Main Methods:
- Two cases of PCNL are described.
- Air pyelography was utilized to visualize the pelvicalyceal system for surgical planning and access.
- Fluoroscopic guidance was employed during the procedure.
Main Results:
- Air pyelography successfully delineated the pelvicalyceal anatomy in both cases.
- Safe renal access was achieved during PCNL using air pyelography.
- No contrast-induced anaphylaxis occurred.
Conclusions:
- Air pyelography is a viable and safe alternative to iodinated contrast for renal access in PCNL.
- This technique is particularly beneficial for patients with a history of contrast hypersensitivity.
- Air pyelography facilitates successful PCNL in high-risk patients.
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