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Massive haemorrhage presenting as a complication after percutaneous nephrolithotomy (PCNL)
11st Department, Silesian Medical Academy, Katowice, Poland.
International Urology and Nephrology
|January 1, 1996
Summary
Massive hemorrhage after percutaneous nephrolithotomy (PCNL) is rare, occurring in 0.3% of patients. Arteriovenous fistulae and aneurysms were identified as causes in some cases, with nephrectomy needed for one patient.
Area of Science:
- Urology
- Vascular Surgery
- Interventional Radiology
Background:
- Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stones.
- Massive hemorrhage is a potential, though infrequent, complication of PCNL.
- Prompt diagnosis and management are crucial for patient outcomes.
Purpose of the Study:
- To report and analyze cases of massive hemorrhage following PCNL.
- To identify the causes of post-PCNL hemorrhage.
- To discuss management strategies for this complication.
Main Methods:
- Retrospective review of patients who underwent PCNL.
- Identification of patients experiencing massive hemorrhage.
- Utilizing renal arteriography to diagnose vascular abnormalities.
- Documenting treatment interventions, including nephrectomy.
Main Results:
- Massive hemorrhage occurred in 0.3% (10/3080) of patients post-PCNL.
- Renal arteriography revealed arteriovenous fistulae in 4 patients and renal artery branch aneurysms in 2.
- Hemorrhage source was not identified by arteriography in 4 patients.
- One patient required nephrectomy to control bleeding.
Conclusions:
- Massive hemorrhage post-PCNL is a significant complication requiring vigilant monitoring.
- Renal arteriography is a key diagnostic tool for identifying vascular causes.
- Management may range from conservative measures to surgical intervention like nephrectomy.