CTICasesIatrogenic Hemothorax Complicating Percutaneous Nephrolithotomy
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Imaging findings
Chest radiographs show a moderate-to-large right pleural effusion. Non-contrast abdominal CT demonstrates high-attenuation fluid within the right pleural space (hemothorax) and a small amount of perinephric hematoma, status post-percutaneous nephrolithotomy (kidney lithotripsy) and retrograde ureteral stent placement.
Key takeaways
Hemothorax and pleural effusion are known complications of percutaneous renal access procedures, particularly when an upper pole kidney access is selected by the urologist. This approach provides an advantageous angle for instrumentation but risks nicking the intercostal vessels and transgressing the pleura, leading to bleeding into the pleural space.
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