Document Detail

Diagnosis and management of complications of percutaneous nephrolithotomy.
MedLine Citation:
PMID:  2924589     Owner:  NLM     Status:  MEDLINE    
The therapeutic management of the complications of percutaneous nephrolithotomy (PNL) depends on the early recognition of these complications. A review of 720 cases revealed the incidence of significant complications to be less than 4%. An algorithm was developed as a guideline for the diagnosis and management of complications of PNL. Early complications included transient bleeding (83 cases), extravasation of urine (52 cases), significant infection (11 cases [2 with septicemia and shock]), and migration of stone fragments into the retroperitoneum (7 cases). Nonrenal complications were present in less than 6% of these patients. These included pleural effusions or pneumothorax (24 cases) and lung atelectasis (19 cases). Late complications were seen in less than 2% of the patients. These included stricture of the ureter with obstruction (5 cases), A-V fistula with or without pseudoaneurysm (7 cases), and subcapsular hematoma (1 case). Therapeutic management included improvement of technique to the use of antibiotics to treat infection. The use of proper drainage and the placement of stent or catheter in the treatment and prevention of further complications has become an integral part of the algorithm for the treatment of complications of PNL. This algorithm recommends the proper diagnostic modality for the detection and evaluation of the extent of the complication. Once detected, the complications of PNL can be minimized with limited permanent changes.
G W Moskowitz; W J Lee; R Pochaczevsky
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical reviews in diagnostic imaging     Volume:  29     ISSN:  1040-8371     ISO Abbreviation:  Crit Rev Diagn Imaging     Publication Date:  1989  
Date Detail:
Created Date:  1989-05-02     Completed Date:  1989-05-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8914817     Medline TA:  Crit Rev Diagn Imaging     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-12     Citation Subset:  IM    
Department of Radiology, Long Island Jewish Medical Center New Hyde Park, New York.
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MeSH Terms
Aged, 80 and over
Bacterial Infections / complications
Contrast Media / adverse effects
Hematuria / complications
Kidney Calculi / diagnosis,  surgery*,  therapy
Middle Aged
Nephrostomy, Percutaneous* / adverse effects
Postoperative Care
Reg. No./Substance:
0/Contrast Media

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