Advertisement

Clinical implications of acute pelvicaliceal hematoma formation during percutaneous catheter nephrostomy insertion

      Highlights

      • Intra-procedural pelvicaliceal hematoma formation occurred in 21% of PCN insertions.
      • There was a very low incidence of clinically significant blood loss, catheter obstruction, or delayed return to baseline renal function in patients with intra-procedural pelvicaliceal hematomas.
      • The results suggest that intra-procedural pelvicaliceal hematoma formation is a relatively benign and self-limited phenomenon.

      Abstract

      Purpose

      To determine the clinical implications of acute pelvicaliceal hematoma formation during percutaneous catheter nephrostomy (PCN) insertion.

      Methods

      Collecting system hematoma burden was retrospectively assessed for 694 PCN insertions in 502 patients.

      Results

      Pelvicaliceal hematoma formation occurred in 146 kidneys (21%) in 136 patients. Clinically significant blood loss occurred in 3 patients with hematomas within one week compared to 4 patients without hematomas (p = 0.39). Twenty-four patients with hematomas underwent catheter exchange within one week, compared to 55 patients without hematomas (p = 0.49).

      Conclusion

      Pelvicaliceal hematoma formation after PCN insertion is not uncommon and is associated with very rare clinical sequelae.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wah T.M.
        • Weston M.J.
        • Irving H.C.
        Percutaneous nephrostomy insertion: outcome data from a prospective multi-operator study at a UK training centre.
        Clin Radiol. 2004; 59: 255-261
        • Hausegger K.A.
        • Portugaller H.R.
        Percutaneous nephrostomy and antegrade ureteral stenting: technique-indications-complications.
        Eur Radiol. 2006; 16: 2016-2030
        • Lewis S.
        • Patel U.
        Major complications after percutaneous nephrostomy—lessons from a department audit.
        Clin Radiol. 2004; 59: 171-179
        • Radecka E.
        • Magnusson A.
        Complications associated with percutaneous nephrostomies. a retrospective study.
        Acta Radiol. 2004; 45: 184-188
        • Farrell T.A.
        • Hicks M.E.
        A review of radiologically guided percutaneous nephrostomies in 303 patients.
        J Vasc Interv Radiol: JVIR. 1997; 8: 769-774
        • Wang Y.
        • Lu Z.
        • Hu J.
        • et al.
        Renal access by sonographer versus urologist during percutaneous nephrolithotomy.
        Urol J. 2013; 10: 1035-1039
        • Patel U.
        • Jeon J.H.
        • Kumar S.
        Thirty-day outcomes after percutaneous nephrostomy of renal transplant kidneys: 19-year experience and comparison with existing practice parameters.
        AJR Am J Roentgenol. 2015; 205: 1326-1331
        • Claudio Vignali S.L.
        • Bargellini Irene
        • Cioni Roberto
        • Petruzzi Pasquale
        • Caramella Davide
        • Bartolozzi Carlo
        Vascular injuries after percutaneous renal procedures: treatment by transcatheter embolization.
        Eur Radiol. 2004; 14: 723-729
        • Eden G.
        • Archinti M.
        • Furlan F.
        • Murphy R.
        • Degryse B.
        The urokinase receptor interactome.
        Curr Pharm Des. 2011; 17: 1874-1889
        • Degryse B.
        The urokinase receptor system as strategic therapeutic target: challenges for the 21st century.
        Curr Pharm Des. 2011; 17: 1872-1873