Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case report
Abstract Background Renal arteriovenous fistula was rarely reported in retrograde endoscopic procedure. Up to now, there is still an absence of report on the formation of renal arteriovenous fistula after semi-rigid ureteroscopic lithotripsy for lower ureteral stones. Case presentation An 83-year-ol...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-08-01
|
| Series: | BMC Urology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12894-020-00688-1 |
| _version_ | 1819205386543038464 |
|---|---|
| author | Wan-Zhang Liu Ting Huang Li Fang Yue Cheng |
| author_facet | Wan-Zhang Liu Ting Huang Li Fang Yue Cheng |
| author_sort | Wan-Zhang Liu |
| collection | DOAJ |
| description | Abstract Background Renal arteriovenous fistula was rarely reported in retrograde endoscopic procedure. Up to now, there is still an absence of report on the formation of renal arteriovenous fistula after semi-rigid ureteroscopic lithotripsy for lower ureteral stones. Case presentation An 83-year-old man was admitted to our hospital complaining about intermittent left flank pain that had persisted for 1 week. He suffered medium hypertension and nephrolithiasis treated with left open ureterolithotomy and two ureteroscopic lithotripsies. Non-contrast abdominal CT scan revealed two left lower ureteral stones diametered 8 mm and 7 mm respectively with mild hydronephrosis. A retrograde semi-rigid ureteroscopic lithotripsy was performed to remove the stones, after which two Double-J stents were placed for the ureteral stricture. Due to the continuous gross hematuria and hemoglobin droppings 2 days after operation, a variety of conservative therapies, including blood transfusion and bed rest, were adopted. Then, the patient was discharged with a stable hemoglobin. However, he presented himself to our emergency department with aggravating left flank pain and severe gross hematuria as little as 2 days later. Emergent digital subtraction angiography was conducted to reveal an arteriovenous fistula in the left kidney, which was embolized with two platinum coils to stop the bleeding. His hematuria was resolved in 3 days, and two Double-J stents were removed in 4 weeks. The patient was followed up for 1 year, during which no hematuria or flank pain recurred. Conclusion This is the first case report on the formation of renal arteriovenous fistula after semi-rigid ureteroscopic lithotripsy. In this case, elevated intrapelvic pressure, historical surgery and hydronephrosis might be associated with the primary risk of the complication. |
| first_indexed | 2024-12-23T04:50:53Z |
| format | Article |
| id | doaj.art-8450b0f6eb1e47ba8ba760e819d82c9a |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-12-23T04:50:53Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-8450b0f6eb1e47ba8ba760e819d82c9a2022-12-21T17:59:27ZengBMCBMC Urology1471-24902020-08-012011510.1186/s12894-020-00688-1Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case reportWan-Zhang Liu0Ting Huang1Li Fang2Yue Cheng3Department of Urology, NingBo First Hospital, NingBo Hospital of ZheJiang UniversityDepartment of Urology, NingBo First Hospital, NingBo Hospital of ZheJiang UniversityDepartment of Urology, NingBo First Hospital, NingBo Hospital of ZheJiang UniversityDepartment of Urology, NingBo First Hospital, NingBo Hospital of ZheJiang UniversityAbstract Background Renal arteriovenous fistula was rarely reported in retrograde endoscopic procedure. Up to now, there is still an absence of report on the formation of renal arteriovenous fistula after semi-rigid ureteroscopic lithotripsy for lower ureteral stones. Case presentation An 83-year-old man was admitted to our hospital complaining about intermittent left flank pain that had persisted for 1 week. He suffered medium hypertension and nephrolithiasis treated with left open ureterolithotomy and two ureteroscopic lithotripsies. Non-contrast abdominal CT scan revealed two left lower ureteral stones diametered 8 mm and 7 mm respectively with mild hydronephrosis. A retrograde semi-rigid ureteroscopic lithotripsy was performed to remove the stones, after which two Double-J stents were placed for the ureteral stricture. Due to the continuous gross hematuria and hemoglobin droppings 2 days after operation, a variety of conservative therapies, including blood transfusion and bed rest, were adopted. Then, the patient was discharged with a stable hemoglobin. However, he presented himself to our emergency department with aggravating left flank pain and severe gross hematuria as little as 2 days later. Emergent digital subtraction angiography was conducted to reveal an arteriovenous fistula in the left kidney, which was embolized with two platinum coils to stop the bleeding. His hematuria was resolved in 3 days, and two Double-J stents were removed in 4 weeks. The patient was followed up for 1 year, during which no hematuria or flank pain recurred. Conclusion This is the first case report on the formation of renal arteriovenous fistula after semi-rigid ureteroscopic lithotripsy. In this case, elevated intrapelvic pressure, historical surgery and hydronephrosis might be associated with the primary risk of the complication.http://link.springer.com/article/10.1186/s12894-020-00688-1Renal arteriovenous fistulaSevere bleedingComputed tomography angiographyDigital subtraction angiographyCase report |
| spellingShingle | Wan-Zhang Liu Ting Huang Li Fang Yue Cheng Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case report BMC Urology Renal arteriovenous fistula Severe bleeding Computed tomography angiography Digital subtraction angiography Case report |
| title | Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case report |
| title_full | Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case report |
| title_fullStr | Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case report |
| title_full_unstemmed | Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case report |
| title_short | Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case report |
| title_sort | renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones a rare case report |
| topic | Renal arteriovenous fistula Severe bleeding Computed tomography angiography Digital subtraction angiography Case report |
| url | http://link.springer.com/article/10.1186/s12894-020-00688-1 |
| work_keys_str_mv | AT wanzhangliu renalarteriovenousfistulaafterretrogradeureteroscopiclithotripsyforthelowerureteralstonesararecasereport AT tinghuang renalarteriovenousfistulaafterretrogradeureteroscopiclithotripsyforthelowerureteralstonesararecasereport AT lifang renalarteriovenousfistulaafterretrogradeureteroscopiclithotripsyforthelowerureteralstonesararecasereport AT yuecheng renalarteriovenousfistulaafterretrogradeureteroscopiclithotripsyforthelowerureteralstonesararecasereport |