Ertürk KARAAĞAÇ, Kamil Gökhan ŞEKER, Adem REYHANCAN, Ramazan AZAR, Ali Ertan ULUCAN

A perfect storm: Open surgical approach to iatrogenic abdominal aortic injury developed during percutaneous nephrostomy

Percutaneous nephrostomy catheter insertion allows the diagnosis and treatment of many pathologies from kidney failure to infection and obstruction. Vascular injuries are considered one of the complications of percutaneous interventions and are rarely seen after percutaneous nephrostomy catheter insertion. Herein, we report the first case of the successful surgical treatment of iatrogenic abdominal aortic injury after percutaneous nephrostomy catheter insertion in a 78-year-old female patient who developed hydroureteronephrosis and acute renal failure due to obstructive ureteral stone in the right proximal ureter.

Beklenmedik bir sonuç: Perkütan nefrostomi sırasında gelişen iyatrojenik abdominal aort yaralanmasında açık cerrahi yaklaşım

Perkütan nefrostomi kateter yerleştirilmesi, böbrek yetmezliğinden enfeksiyon ve tıkanıklığa kadar pek çok patolojinin tanı ve tedavisine olanak sağlar. Vasküler yaralanmalar, perkütan girişimlerin komplikasyonlarından biri olarak kabul edilir ve perkütan nefrostomi kateteri takıldıktan sonra nadiren görülür. Bu makalede, sağ proksimal üreterde tıkayıcı üreter taşına bağlı olarak hidroüreteronefroz ve akut böbrek yetmezliği gelişen 78 yaşında bir kadın hastada, perkütan nefrostomi kateteri takılması sonrası saptanan iyatrojenik abdominal aort yaralanmasının ilk başarılı cerrahi tedavisi sunuldu.

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1. Lessne ML, Holly B, Huang SY, Kim CY. Diagnosis and management of hemorrhagic complications of interventional radiology procedures. Semin Intervent Radiol 2015;32:89-97.
2. Kaskarelis IS, Papadaki MG, Malliaraki NE, Robotis ED, Malagari KS, Piperopoulos PN. Complications of percutaneous nephrostomy, percutaneous insertion of ureteral endoprosthesis, and replacement procedures. Cardiovasc Intervent Radiol 2001;24:224-8.
3. Chen XF, Chen SQ, Xu LY, Gong Y, Chen ZF, Zheng SB. Intravenous misplacement of nephrostomy tube following percutaneous nephrolithotomy: Three new cases and review of seven cases in the literature. Int Braz J Urol 2014;40:690-6.
4. Mazzucchi E, Mitre A, Brito A, Arap M, Murta C, Srougi M. Intravenous misplacement of the nephrostomy catheter following percutaneous nephrostolithotomy: two case reports. Clinics (Sao Paulo) 2009;64:69-70.
5. Monzio-Compagnoni N, Aseni P, Romani F. Emergency aortic control for pedicle screw misplacement during spinal fixation. Ann Vasc Surg 2020;66:669.e1-669.e3.
6. Berthet JP, Marty-Ané CH, Veerapen R, Picard E, Mary H, Alric P. Dissection of the abdominal aorta in blunt trauma: Endovascular or conventional surgical management? J Vasc Surg 2003;38:997-1003.
7. Gunn M, Campbell M, Hoffer EK. Traumatic abdominal aortic injury treated by endovascular stent placement. Emerg Radiol 2007;13:329-31.