Page kidney post ureteroscopy: a case report

Abstract

Renal injury after surgical intervention is not uncommon in current urological practice with most complication would be anticipated in high risk patient. Subcapsular renal hematoma is not known complication post some urological interventions such as extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and trauma. Few cases of subcapsular hematomas are reported as a complication post ureteroscopy in the literature. Clinical spectrum varies from spontaneous resolution through acute renal failure secondary to Page kidney. Page kidney is the external compression of a kidney usually caused by a subcapsular hematoma associated with high blood pressure and occasional renal failure. It is named after Dr. Irvin Page who first demonstrated in 1939 that applying external compression on the renal parenchyma could cause hypertension. Various management options are mentioned in literature and depend upon the severity and presentation. Percutaneous drainage is an option for the management of subcapsular hematoma in hemodynamically stable patient.

A Rare Case of Page Kidney With Superimposed Infection

“…Treatment with antihypertensives is initiated to control the patient's blood pressure and prevent further propagation of the renal subcapsular hematoma. The subcapsular hematoma will typically resolve within three weeks, but if no resolution occurs, the hematoma may require surgical intervention through percutaneous drainage, nephrectomy, or capsulectomy to control hypertension and further complications [15,16].…”

Case report: Page kidney with multiple serosal effusions caused by bilateral spontaneous renal subcapsular hemorrhage

“…Page kidney is a rare urological disease in which perirenal or subcapsular blood or fluid accumulation compresses the renal parenchyma and triggers the activation of the reninangiotensin-aldosterone axis, leading to systemic hypertension (1). In recent years, most reported cases of Page kidney are mainly caused by trauma and iatrogenic injury, which is related to blunt trauma of the kidney or invasive diagnosis and treatment operations in and around the kidney, and non-traumatic or spontaneous causes of cases are rare (1)(2)(3)(4). Polyserous effusion is a common and difficult clinical disease that refers to the simultaneous effusion of two or more serous cavities (pericardial cavity, thoracic cavity, and abdominal cavity).…”