Massive retroperitoneal hematoma as an acute complication of retrograde intrarenal surgery:A case report  

作　　者：Taesoo Choi Jeonghyouk Choi Gyeong Eun Min Dong-Gi Lee 

机构地区：[1]Department of Urology,School of Medicine,Kyung Hee University,Seoul 05278,South Korea

出　　处：《World Journal of Clinical Cases》2021年第16期3914-3918,共5页世界临床病例杂志

摘　　要：BACKGROUND Retrograde intrarenal surgery(RIRS)has been proven to be a safe and effective treatment modality in large-scale quantitative studies.However,although its safety profile has been established,it also has a potential risk of life-threatening complications.We here describe our experience with a patient who developed a huge periureteral hematoma after RIRS with holmium laser lithotripsy.CASE SUMMARY A 73-year-old woman visited our center with a complaint of gross hematuria.An enhanced computed tomography(CT)scan revealed a 1.5-cm left renal pelvis stone with hydronephrosis.The patient underwent RIRS.During the surgery,a 12/14-Fr ureteral access sheath was applied and a 6-Fr ureteral catheter was indwelled thereafter.On postoperative day 1,she experienced aggravated left flank pain and left lower-quadrant tenderness without rebound tenderness.A follow-up CT scan was taken,which revealed a huge hematoma in the periureteral space,not in the perirenal space,with suspicious contrast medium extravasation.Immediate angiography was performed;however,it showed no evidence of active bleeding.She was conservatively managed with hydration and antibiotic and nonsteroidal anti-inflammatory drug therapy,and was discharged on postoperative day 7.However,she visited our outpatient department with recurrent left flank pain at 5 d from discharge.Ultrasonography confirmed that the double J-stent was intact.To rule out stent malfunction,the stent was changed.Decreased size of the hematoma was observed in the imaging studies,and conservative management for candiduria was performed for 1 wk.CONCLUSION Although RIRS is an effective and safe procedure for the management of renal stones,clinicians should be aware of its potential complications.

关 键 词：Retroperitoneal hematoma Ureteral access sheath Retrograde intrarenal surgery Acute complication Case report 

分 类 号：R699.2[医药卫生—泌尿科学]