Management of iatrogenic urinothorax following ultrasound guided percutaneous nephrostomy

Authors

  • Deepak Batura
  • Patricia Haylock-Vize
  • Yaser Naji
  • Rachel Tennant
  • Katherine Fawcett

DOI:

https://doi.org/10.3941/jrcr.v8i1.1424

Keywords:

Urinothorax, percutaneous nephrostomy, reno-pleural fistula, complication, prostate cancer, ureteral stent

Abstract

A 64 year-old male with metastatic prostate adenocarcinoma presented with bilateral hydronephrosis and renal impairment. Bilateral percutaneous nephrostomy drainage followed by ante-grade stenting was done. Shortly afterwards, the patient developed an extensive left-sided pleural effusion. His serum creatinine rose and he became anuric. Emergency pleural aspiration and later, pleural drainage were performed. Pleural aspirate was diagnostic of urinothorax and non contrast CT scan demonstrated a left reno-pleural fistula. The right stent was removed cystoscopically. The left stent could not be removed cystoscopically and was replaced in an ante grade manner through a fresh percutaneous renal approach. This led to cessation of pleural fluid accumulation. The patient was discharged with bilateral ureteric stents and normal renal function. A month later, he had normal renal function, no hydronephrosis and normal chest x-rays.

Author Biographies

Deepak Batura

Department of Urology

Consultant  

Patricia Haylock-Vize

Department of Urology

House Officer

Yaser Naji

Department of Interventional Radiology

Consultant

Rachel Tennant

Department of Respiratory Medicine

Consultant

Katherine Fawcett

Department of respiratory Medicine

Specialist Registrar

Published

2014-01-28

Issue

Section

Genitourinary Radiology