Splenic Injury During Percutaneous Nephrolithotomy: A Case Report with Novel Management Technique

Desai, Alana; Jain, Samay; Benway, Brian M.; Grubb, Robert L.; Picus, Daniel; Figenshau, Robert S.

doi:10.1089/end.2009.0290

Cited by 21 publications

(14 citation statements)

References 32 publications

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“…In human surgery, the use of topical haemostatic agents has been advocated for select cases of low‐grade haemorrhage emanating from the splenic surface (Desai et al . ). The size of the defect in this instance was considered too large for such a reparative measure.…”

Section: Discussionmentioning

confidence: 97%

Concurrent repair of a displaced rib fracture and splenic capsular tearing using laparoscopic technique in a standing horse with acute haemoperitoneum

O’Neill¹,

Ricardi²

2018

Equine Veterinary Education

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Summary Splenic trauma as a sequela to rib fracture is a recognised cause of haemoperitoneum in the horse. Although surgical repair to those areas damaged is advocated as the treatment of choice, information pertaining to the simultaneous repair of such sites is lacking. Additionally, the hypovolaemic case presents a separate anaesthetic challenge. This report is the first published description of a concurrent approach for a displaced rib fracture and an associated splenic capsular tear using laparoscopic technique in a standing sedated horse with acute haemoperitoneum. The rib fracture was reduced and stabilised using polyamide ties, and the splenic capsular tear repaired using intracorporeal suturing with knotless, unidirectional barbed suture. Total surgery time was 90 min and no complications were encountered during the procedure. The mare was discharged 6 days post‐operatively. Organ orientation in the standing case afforded excellent visibility to both the parietal surface of the spleen and fractured rib, and abolished the necessity for general anaesthesia.

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Section: Discussionmentioning

confidence: 97%

Concurrent repair of a displaced rib fracture and splenic capsular tearing using laparoscopic technique in a standing horse with acute haemoperitoneum

O’Neill¹,

Ricardi²

2018

Equine Veterinary Education

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“…Desai et al reviewed a similar complication managed by concurrent ureteral stent and trans-splenic percutaneously introduced Gelfoam ® pledgets on POD 2. 10 Similarly, Thomas described a technique wherein a collagen–thrombin hemostatic sealant (D-Stat; Vascular Solutions, Inc., Minneapolis, MN) was introduced through the nephrostomy tube during removal in the interventional radiology suite. 11 Both patients had uneventful recovery periods.…”

Section: Discussionmentioning

confidence: 99%

Conservative Management of Combined Pleural and Splenic Injury During Percutaneous Nephrostolithotomy

GaunayGeoffrey

AhmedHaris

SmithArthur

et al. 2016

Journal of Endourology Case Reports

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“…Splenic injury leading to splenectomy can occur with a multitude of urological operations, not only transabdominal left radical nephrectomy. Recently, there have been reports of injury to the spleen during laparoscopic urological surgery, and even percutaneous nephrolithotomy . The common link among these procedures is the mechanism of injury, which is most commonly related to misplaced traction and tension on the spleen, leading to capsular tears and lacerations.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic splenectomy during nephrectomy for renal tumors

et al. 2013

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Abbreviations & AcronymsObjectives: To evaluate risk factors associated with iatrogenic splenectomy during nephrectomy and to assess outcomes among patients undergoing nephrectomy for renal tumors. Methods: Of 4323 patients who underwent nephrectomy at Mayo Clinic between 1992 and 2008, 33 (0.8%) had an iatrogenic/unplanned splenectomy. In a case-control study design, controls without splenectomy were matched 1:3 based on age, sex, surgical date, side of the renal tumor, surgical approach and surgeon. Perioperative features and survival were evaluated using conditional logistic and Cox regression. Results: Among the 33 iatrogenic splenectomy patients, the majority (94%) underwent radical, open and left-sided nephrectomy. Primary tumor classification ՆT3 was the only clinicopathological risk factor significantly associated with splenectomy (odds ratio 3.4; P = 0.02). Compared with controls, patients with an iatrogenic splenectomy were more likely to have longer operative time (205 vs 171 min; P = 0.02), higher estimated blood loss (1.3 vs 0.3 L; P = 0.001), longer length of stay (median 7 vs 5 days; P = 0.03) and a higher likelihood for postoperative complications (odds ratio 5.3; P = 0.002). With a median of 9.8 years of follow up, splenectomy patients tended to have greater all-cause mortality (hazard ratio 1.6; P = 0.07), although this difference approached statistical significance. Conclusions: Iatrogenic splenectomy is a rare complication during nephrectomy and is associated with locally advanced tumors (ՆpT3). It also carries prognostic significance for adverse perioperative outcomes and possibly diminished survival, although this warrants further study.

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Splenic Injury During Percutaneous Nephrolithotomy: A Case Report with Novel Management Technique

Cited by 21 publications

References 32 publications

Concurrent repair of a displaced rib fracture and splenic capsular tearing using laparoscopic technique in a standing horse with acute haemoperitoneum

Concurrent repair of a displaced rib fracture and splenic capsular tearing using laparoscopic technique in a standing horse with acute haemoperitoneum

Conservative Management of Combined Pleural and Splenic Injury During Percutaneous Nephrostolithotomy

Iatrogenic splenectomy during nephrectomy for renal tumors

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