Splenic Injury: Rare Complication of Percutaneous Nephrolithotomy: Report of Two Cases with Review of Literature

Abstract

One of these patients presented with hypotension on day 5 after discharge from the hospital. Both patients needed emergency laparotomy, and one of them required splenectomy for management of the injury. We reviewed the literature to determine the risk factors and management of splenic injury during PCNL.

Prevention and treatment of complications following percutaneous nephrolithotomy

“…Most cases of hepatic injury can be treated conservatively by leaving the nephrostomy tube in place for several days and by close monitoring of the patient [14]. Although some patients with splenic laceration can be treated conservatively, most will require splenectomy [50,51].…”

Iatrogenic hepatic subcapsular biloma following PCNL: Diagnosis and management

“…Accesses through the 10th intercostal space and/ or anterior to the posterior axillary line are major risk factors for adjacent organ injury. 7 In 2008 EL-Nahas and colleagues 5 published the first case report regarding conservative management of liver injury in Fig. 3.…”

Minimizing complications in endourological surgery

“…Injury to spleen and liver can also occur especially if the puncture is made in the 10th intercostal space [43,44] or in presence of associated organomegaly. Colonic injury is also rare (0.2-1%) [10,12].…”