Renal Parenchyma Perforation after Double-J Ureteral Stent Insertion

From Routine to Exceptional: Exploration of a Unique Case of Bilateral Renal Parenchymal Perforation and Unilateral Hematoma Formation after Double J Ureteral Stent Insertion

“…Minor injuries are usually treated conservatively, including careful monitoring of the patient's vital signs, blood transfusions and follow-up imaging. Conversely, large or persistent lesions require immediate intervention with angio-embolization, and possibly further surgery if necessary [8]. Our patient benefited from a stent change.…”

“…The symptomatology is atypical: Irritative signs, lumbar pain of variable intensity, vomiting, hematuria. Liao, et al [8] have reported signs of hemodynamic instability (hypoxia and hypotension). This complication may be discovered in the immediate postoperative period, or after a few weeks, as in the case of this report.…”

“…In the event of uncontrolled bleeding or rapid evolution of the hematoma, conventional drainage by open surgery may be opted for [10]. Therapeutic approaches vary in the literature, and may include stent repositioning [2,5,6], replacement [9] or removal [8]. Management of iatrogenic kidney injury depends on the severity of the injury.…”

“…Since then, their use has become increasingly widespread, in line with the growing number of complications associated with them [1]. Among the multitude of complications, Liao, et al [8] considered perforation of the renal parenchyma caused by double-J stent insertion to be a very rare occurrence. Apart from Gönülalan, et al [5], who reported the occurrence of this complication in a patient with a single kidney, all previous studies have reported cases of unilateral involvement.…”

“…To our knowledge, our case is the first with bilateral involvement. Some authors [6,8] have put forward hypotheses concerning the mechanism of occurrence. Their hypothesis consists in explaining the occurrence of this complication by injury to the renal parenchyma caused by the guide wire.…”