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Journal of Endourology May 2017With the broadening indications of ureteroscopy (URS) for complex stones and high-risk patients, more URS is being performed and hence there is an increasing risk of... (Review)
Review
INTRODUCTION
With the broadening indications of ureteroscopy (URS) for complex stones and high-risk patients, more URS is being performed and hence there is an increasing risk of major potentially life-threatening complications. We wanted to define the incidence, predisposing factors, management, and long-term sequelae for post-URS perirenal hematoma (PRH).
MATERIAL AND METHODS
We conducted a systematic review of literature according to Cochrane and preferred reporting items for systematic reviews and meta-analysis guidelines for all studies reporting on post-URS PRH from 1980 to September 2016. A literature search was conducted through PubMed, EMBASE, CINAHL, and Cochrane Library for all English language articles.
RESULTS
Based on a literature search of 210 articles, seven studies (8929 patients) met the inclusion criteria with an incidence of post-URS PRH reported as 0.45% (40 patients, range: 0.15%-8.9% per study) with a mean age of 53 years and a mean stone size of 1.7 cm. The predisposing factors were moderate-severe hydronephrosis, thin renal cortex, prolonged operative duration, hypertension, and preoperative urinary tract infection (UTI). The management strategy varied from conservative management with blood transfusion and antibiotics (n = 22, 55%) to percutaneous drainage (n = 11, 27.5%). Surgical intervention was needed in seven (17.5%) patients. Two of these were emergency angiography of which one proceeded to open nephrectomy. Open surgery with clot removal was done in three patients, nephrostomy for severe hydronephrosis in one patient, and surgery to correct malpositioned stent in one patient. There was one mortality reported, wherein a patient who had postangiography nephrectomy died of multiple organ failure after the intervention.
CONCLUSION
URS related PRH is a rare, but potentially life threatening complication with a small risk of renal loss. Although most cases may be managed conservatively, incidence of PRH can be minimized by control of blood pressure, treatment of preoperative UTI, and reduction in intrarenal pressures and operative time duration.
Topics: Adult; Aged; Drainage; Female; Hematoma; Humans; Hydronephrosis; Incidence; Kidney; Kidney Calculi; Male; Middle Aged; Nephrectomy; Nephrotomy; Operative Time; Stents; Treatment Outcome; Ureteroscopy; Urinary Tract Infections
PubMed: 28001097
DOI: 10.1089/end.2016.0832 -
The New England Journal of Medicine Jun 1949
Topics: Hematoma; Humans; Kidney; Kidney Diseases
PubMed: 18144347
DOI: 10.1056/NEJM194906092402307 -
Ryoikibetsu Shokogun Shirizu 1997
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Medicine Sep 2022Hematomas after percutaneous angiography often occur in the thigh, retroperitoneal, intraperitoneal, or abdominal wall. Renal hematoma after percutaneous angiography is...
RATIONALE
Hematomas after percutaneous angiography often occur in the thigh, retroperitoneal, intraperitoneal, or abdominal wall. Renal hematoma after percutaneous angiography is very rare.
DIAGNOSES
Herein, we present a case of perirenal hematoma and delayed contrast metabolism after cerebral angiograph, which may be caused by improper operation.
INTERVENTIONS
Conservative treatments which development by multi-disciplinary collaboration.
OUTCOMES
After treatment, the clinical symptoms of the patients gradually disappeared and the imaging results became negative.
CONCLUSION
Though the patient missed timely diagnosis and treatment, fortunately no catastrophic events occurred. Meanwhile, the potential causes, diagnosis, and therapeutic management were all discussed.
Topics: Angiography; Gastrointestinal Hemorrhage; Hematoma; Humans; Kidney Diseases; Retroperitoneal Space
PubMed: 36181057
DOI: 10.1097/MD.0000000000030807 -
The Journal of Urology Jul 2017
Topics: Hematoma; Humans; Kidney Diseases; Ureteroscopy
PubMed: 28618680
DOI: 10.1016/j.juro.2017.04.058 -
Urologia Internationalis 2000Spontaneous perirenal hematoma (SPH) is a clinical entity that poses a diagnostic and therapeutic challenge. We report a case of SPH in an adult where the cause could... (Review)
Review
Spontaneous perirenal hematoma (SPH) is a clinical entity that poses a diagnostic and therapeutic challenge. We report a case of SPH in an adult where the cause could not be determined at first presentation, even with computed tomography (CT) of the abdomen and angiography. He was under close follow-up, and it was only with a repeat CT scan after 3 months that a mass lesion in the kidney was identified as the underlying cause. We also present a review of the literature so that a logical approach can be adopted for this problem.
Topics: Hematoma; Humans; Kidney Diseases; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 10895087
DOI: 10.1159/000030533 -
Archivos Espanoles de Urologia Sep 1992We report 10 cases of spontaneous perirenal hematoma that had been treated from 1974 to 1992. Retroperitoneal hemorrhage was secondary to renal disease in 7 cases,... (Review)
Review
We report 10 cases of spontaneous perirenal hematoma that had been treated from 1974 to 1992. Retroperitoneal hemorrhage was secondary to renal disease in 7 cases, perirenal in 2 and extrarenal in 1. The etiology of the condition is analyzed in detail and the diagnostic usefulness of the different radiologic examinations are discussed. Making a preoperative diagnosis permits a more adequate surgical strategy.
Topics: Adolescent; Adult; Child; Female; Hematoma; Humans; Kidney Diseases; Male; Middle Aged
PubMed: 1444607
DOI: No ID Found -
Collegium Antropologicum Jun 2013We are presenting a rare case of a spontaneous extensive perirenal hematoma caused by ruptured renal adenocarcinoma in a patient who was on warfarin therapy because she... (Review)
Review
We are presenting a rare case of a spontaneous extensive perirenal hematoma caused by ruptured renal adenocarcinoma in a patient who was on warfarin therapy because she had atrial fibrillation and three myocardial infarctions. A 77-year-old woman was admitted to our department with acute right flank pain and hemorrhagic shock. The anamnestic data revealed no trauma and hematuria. Abdominal ultrasonography and computed tomography scan showed large retroperitoneal hematoma. The patient underwent urgent surgery and radical nephrectomy was performed. A large retroperitoneal hematoma was found originating from a ruptured renal neoplasm in the upper pole of the right kidney. The pathohistological diagnosis was chromophobe renal cell carcinoma. The clinical, diagnostic and therapeutic peculiarities of this rare condition are presented, along with the literature review on the topic.
Topics: Adenocarcinoma; Aged; Anticoagulants; Atrial Fibrillation; Carcinoma, Renal Cell; Diagnosis, Differential; Female; Hematoma; Humans; Kidney Neoplasms; Warfarin
PubMed: 23941016
DOI: No ID Found -
California Medicine Jan 1962
Topics: Child; Hematoma; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Kidney Diseases
PubMed: 14473736
DOI: No ID Found -
International Journal of... 2019The aim of this study was to discuss the clinical significance of perirenal puncture and drainage with urokinase treatment of perirenal hematoma complicated by infection...
The aim of this study was to discuss the clinical significance of perirenal puncture and drainage with urokinase treatment of perirenal hematoma complicated by infection following surgery for upper urinary tract calculi. Two cases of perirenal hematoma complicated by infection following surgery for upper urinary tract calculi in 2017, and later received perirenal puncture and drainage of perirenal hematoma with urokinase treatment were selected. Puncture and drainage of perirenal hematoma with urokinase treatment were performed without the occurrence of severe complications such as sepsis, septic shock, or secondary bleeding. Both the renal morphology and functions were well restored. Puncture and drainage with urokinase treatment had definite efficacy in the treatment of perirenal hematoma complicated by infection.
Topics: Anti-Bacterial Agents; Gentamicins; Hematoma; Humans; Kidney; Kidney Calculi; Paracentesis; Shock, Septic; Urinary Tract Infections; Urokinase-Type Plasminogen Activator
PubMed: 31238742
DOI: 10.1177/2058738419859696