Flank bulge following supracostal percutaneous nephrolithotomy: a report of 2 cases.

Lantz, Andrea G.

doi:10.5489/cuaj.176

Cited by 5 publications

(4 citation statements)

References 15 publications

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“… 4 Flank bulge after PCNL is rare, but reported in literature in PCNL with supracostal access. 1 However, flank bulge following subcostal PCNL is unheard of and presumably, this is the first reported case.…”

Section: Discussionmentioning

confidence: 85%

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Flank bulge following subcostal percutaneous nephrolithotomy

Chakraborty

Deb

2018

RRU

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Loss of tone of the anterolateral abdominal wall muscles due to denervation injury is quite common after open renal surgery by lumbotomy incision. Although rare, flank bulge following percutaneous nephrolithotomy (PCNL) after supracostal approach has been reported in literature. But pseudohernia after PCNL with subcostal access has not been reported yet. In this case report, we present the rare complication of an abdominal wall bulge that occurred after PCNL with a subcostal access. The index case had been operated for a partial staghorn calculus with lower calyceal extension. PCNL with subcostal approach was used. Complete stone-free status was achieved with an uneventful recovery. During the first follow-up after 1 week, an unsightly, painless flank bulge was noticed, which continued to persist till 9 months of periodic follow-up.

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Section: Discussionmentioning

confidence: 85%

“…Neurological complications are uncommon after PCNL and are usually associated with supracostal approach. 1 Flank bulge after PCNL with subcostal access is unreported yet and is presumed to be due to injury to the main trunk of the subcostal nerve while doing initial puncture or tract formation.…”

Section: Introductionmentioning

confidence: 99%

Flank bulge following subcostal percutaneous nephrolithotomy

Chakraborty

Deb

2018

RRU

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“…Thus, puncture in the lower half of the IC space is potentially safer regarding IC nerve injury [6]. Up to now only three cases of flank muscle tone loss after PСNL are described in the literature [9,10]. Two of them were performed in prone-flexed position through supracostal (12th rib) access and 12th intercostal space, respectively, to upper calyces without nephrostomy drainage [9].…”

Section: Discussionmentioning

confidence: 99%

“…Up to now only three cases of flank muscle tone loss after PСNL are described in the literature [9,10]. Two of them were performed in prone-flexed position through supracostal (12th rib) access and 12th intercostal space, respectively, to upper calyces without nephrostomy drainage [9]. Third case was performed through subcostal access to lower calyx in prone position with nephrostomy drainage after the surgery [10].…”

Section: Discussionmentioning

confidence: 99%

Transient flank bulge after percutaneous nephrolithotomy

Gadzhiev

Aloyan

Petrov

et al. 2023

J Case Rep Images Urol

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Introduction: Percutaneous nephrolithotomy (PCNL) is considered as the “gold standard” treatment for large (>2 cm) and complex kidney stones. We present a case of transient tone loss of the anterolateral abdominal wall, which is a rare complication after PCNL. Case Report: A 50-year-old male with a complete staghorn stone of the right kidney underwent standard PCNL in prone position at the 11th intercostal space. On the 6th post-operative day the patient complained on painless bulge in the right flank. Computed tomography (CT) scan in supine position revealed no signs of herniation, retroperitoneal hematoma, or residual fragments. Flank bulge was attributed to the muscle tone loss either because of the 11th intercostal nerve injury by the needle or nerve compression by the Amplatz sheath. Within next six months flank bulge has completely resolved. Conclusion: Flank bulge after PCNL although rare but possible and transient condition. Nerve injury seems to be the most likely cause.

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