Percutaneous silicon catheter insertion into the IVC, following percutaneous nephrostomy (PCN) exchange

Abstract

case report E505Cite as: Can Urol Assoc J 2013;7(7-8):e505-7. http://dx.doi.org/10.5489/cuaj.1403 Published online on July 2, 2013. AbstractPercutaneous nephrostomy (PCN) has been widely used to drain an infected, obstructed kidney. Few major complications have been associated with it. Few publications have reported the misplacement of nephrostomy tube into the inferior vena cava (IVC), following percutaneous nephrolithotomy. We report a case of a misplaced silicon catheter, through the left renal vein, extending into the IVC, following nephrostomy tube exchange. Our case was safely managed, and we concluded that although PCN and nephrostomy tube exchange are relatively simple procedures, they should be done cautiously, by a well-trained urologist, and preferably under ultrasound or fluoroscopic guidance.

Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

“…The incidence of major complications (4.33%) was similar to previous quoted studies of 1 to 4-5% [21,22]. IVC puncture seen in 1 (1.44%) has been reported earlier as well [23,24]. Significant haemorrhage warranting transfusion or surgery has been uniformly found to be the most common major complications accounting for 5.3% cases [6].…”

Incidental misplacement of a percutaneous nephrostomy tube in the inferior vena cava

“…In some reported cases the guidewire curled within the calyx itself, resulting in a vein puncture following dilation of the tract [8]. Placement of the PCN in the renal vein and vena cava is an uncommon complication, with a total of 10 cases reported in the literature to date (Table 1) [8][9][10][11][12][13][14][15]. A majority of these 10 cases occurred in patients follow the puncture route through the vein and after dilatation, the PCN will be eventually placed through the renal vein into the lumen of the inferior vena cava [8,16].…”

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“…21,22 IVC puncture seen in 1(1.44%) has been reported earlier as well. 23,24 Significant haemorrhage warranting transfusion or surgery has been uniformly found to be the most common major complications accounting for 5.3% cases. 6 In our study, 2.89% had significant haemorrhage requiring blood transfusion whereas minor bleeding was seen in 8.69% patients which resolved spontaneously with observation and occasional flushing of the catheter.…”