Pulmonary emboli associated with coagulum pyelolithotomy

Coagulum pyelolithotomy has become a popular means to extract renal calculi in selected circumstances. Serious complications with this procedure have not been previously reported. A case report of an operative death due to a pulmonary embolus is presented, because of which we designed a canine laboratory study to determine the relationship between coagulum injection into the renal pelvis and thrombo-embolic phenomena. Positive lung scans were detected in a large number of animals related to the volume of the coagulum used and the concentration of the thrombin injected. Judicious use of this procedure with suggested cautions is proposed.