Iatrogenic hydrohemothorax during percutaneous nephrolithotomy: A case report

Tae Yeon Kim, Kyu Nam Kim *, Lee Kwang Hyun, Bo Seok Kwon and Jo Hyung Jun

Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul, Korea.
 
Case Report
Open Access Research Journal of Multidisciplinary Studies, 2021, 01(02), 079–082.
Article DOI: 10.53022/oarjms.2021.1.2.0011
Publication history: 
Received on 23 March 2021; revised on 20 July 2021; accepted on 23 July 2021
 
Abstract: 
Background: Percutaneous nephrolithotomy (PNL) is a widely used surgical method for renal stone management. However, it can be associated with several complications.
Case: We report an acute hemothorax during PNL in 57-year-old male patient with a stone. After observing air bubbles at the diaphragm on the laparoscopic screen, we considered pulmonary complications. A chest radiograph demonstrated a shade that measured 130 mm wide and 70 mm long and fluid retention on the right side of the chest. During drainage of 200 ml of blood through a chest tube, the patient’s vital signs became unstable. After the patient received hydration and intravenous injection of vasopressor, his vital signs stabilized.
Conclusions: Pulmonary complications due to pleural injury during PNL can result in death, but the complications can be managed by early diagnosis and treatment. Close cooperation between surgeon and anesthesiologist and routine chest radiographs after PNL can reduce the pulmonary complications.
 
Keywords: 
Complications; Iatrogenic diaphragmatic injury; Hemothorax; Percutaneous nephrolithotomy; Supracostal approach
 
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