scholarly journals Case Report: An occurrence of steinstrasse in retrograde intra renal surgery for a large staghorn kidney stone – difficulty managing surgical outcomes

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 184
Author(s):  
Ponco Birowo ◽  
Nur Rasyid ◽  
Widi Atmoko ◽  
Bobby Sutojo

Immediate removal of staghorn stones is compulsory to prevent life-threatening complications. The advancement of endoscopic technology makes retrograde intrarenal surgery (RIRS) a favorable treatment to remove large stones over the standard percutaneous nephrolithotomy (PCNL). Without careful considerations, it can cause the formation of steinstrasse. Here, we present the case of a 68-year-old man with multiple stones along his right urogenital duct after being treated with RIRS to remove a staghorn stone. After 2 years of multiple interventions, the steinstrasse was completely removed. To prevent this complication, detailed assessment of the stone (size, location) and renal anatomy should be performed prior to the procedure.

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 184
Author(s):  
Ponco Birowo ◽  
Nur Rasyid ◽  
Widi Atmoko ◽  
Bobby Sutojo

Immediate removal of staghorn kidney stones is important to prevent life-threatening complications. With the advancement of endoscopic technology, retrograde intrarenal surgery (RIRS) is now an alternate treatment to the standard percutaneous nephrolithotomy (PCNL) for stones removal. However, when used to treat large stones (>3cm), RIRS can cause the formation steinstrasse (SS). Here, we present the case of a 68-year-old man with multiple stones in the collecting system of the right kidney after initial treatment with RIRS. After two years of multiple interventions, the SS was completely removed. To prevent this complication in patients, a detailed assessment of the stone (size, location) and renal anatomy should be completed before RIRS is performed.


2021 ◽  
Vol 93 (3) ◽  
pp. 318-322
Author(s):  
Bulent Kati ◽  
Eyyup Sabri Pelit ◽  
Mehmet Demir ◽  
Ismail Yagmur ◽  
Adem Tuncekin ◽  
...  

Objective: The management of urolithiasis in patients with a solitary kidney is challenging for urologists. This study aimed to evaluate the safety of retrograde intrarenal surgery (RIRS) in the treatment of stones in patients with solitary kidney and to reply to the question if there is any limit for this surgery. Methods: Between January 2016 and December 2019, we enrolled 52 patients who had a solitary kidney and underwent RIRS. We collected data on preoperative patient characteristics, stone dimensions, and postoperative outcomes. Stone size, duration of operation, duration of fluoroscopy, type of anesthesia, and degree of surgical complication were evaluated retrospectively. Surgeries performed in less and more than 60 minutes and with and without complications were compared. Results: A total of 52 patients with a kidney stone and a solitary kidney were evaluated. The mean stone size was 14 ± 0.4 cm and surgical success rate was 87.3%. In our study, 13 patients (24.5%) had grade 1 minor complications, and none required a blood transfusion. The mean operation time was 51.9 ± 17.3 minutes. The postoperative creatinine value increased in 6 patients. The duration of operation in the group with complications was significantly higher than that in the group without complications. In patients who underwent an operation lasting ≥ 60 minutes, stone size, fluoroscopy time, and complication rate were significantly higher than in patients who underwent an operation lasting ≤ 60 minutes. Conclusion: Our opinion is to be careful in patients with a solitary kidney with a big stone and we recommend assigning these procedure to experienced hands for not exceeding 60 minutes in one session.


F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 24 ◽  
Author(s):  
Ashley G. Winter ◽  
Ranjith Ramasamy

Heparin-induced thrombocytopenia (HIT) can cause severe life-threatening events such as bilateral adrenal hemorrhage (BAH). A 48-year-old female developed a pulmonary embolus (PE) following partial nephrectomy. The anticoagulation treatment for her PE was complicated by HIT and subsequent BAH. To the author’s knowledge, this is the first reported case of HIT-associated BAH following renal surgery.


2007 ◽  
Vol 177 (4S) ◽  
pp. 420-420
Author(s):  
Igor Sergeyev ◽  
Philip T. Koi ◽  
Stacy L. Jacobs ◽  
Alia Godelman ◽  
David M. Hoenig

2021 ◽  
pp. 039156032110366
Author(s):  
Mustafa Erkoc ◽  
Muammer Bozkurt ◽  
Eyyüp Danis ◽  
Osman Can

Mini-Percutaneous Nephrolithotomy (M-PCNL) and Retrograde Intrarenal Surgery (RIRS) are commonly used methods in treatment of kidney stones. The aim of our study is to compare the efficacy and safety of M-PCNL and RIRS in kidney stone treatment over 50 years old patients. A total of 125 patients, 65 of whom had RIRS, and 60 of whom had M-PCNL, were included in the study. Age, gender, BMI (Body-Mass Index), ASA (American Society of Anesthesiology) scores of the patients; stone size, stone location, operation side, ESWL history, HU (Hounsfield Unit) values, hospital stay durations, SFR, complication rates according to Clavien modification system, postoperative hemoglobin loss, postoperative transfusion rates, and patients who needed a secondary operation were recorded. SFR values were calculated in the postoperative third and sixth months. The data between the two groups had similar characteristics in terms of age, gender, BMI, HU, stone size, operation side, stone location, ESWL history, operation time, postoperative transfusion rate, postoperative Clavien complications ( p > 0.05). When the ASA categories were evaluated, the mean ASA scores, ASA I, and ASA II data had similar characteristics in both groups ( p > 0.05). When the ASA 3 scores were evaluated, the number of ASA III patients in the RIRS group was statistically significantly higher ( p < 0.05). When hospital stay duration and postoperative hemoglobin loss were examined, RIRS group was found to be advantageous ( p < 0.05). Postoperative third month SFR and Postoperative sixth month values were statistically significantly higher in M-PCNL group ( p < 0.05). M-PCNL and RIRS are methods that can be used safely and effectively over 50 years old patients in kidney stone surgery. M-PCNL has been found to be more advantageous in terms of SFR rates and as it requires less secondary intervention. RIRS is advantageous in terms of short hospital stay, postoperative hemoglobin loss, and applicability to patients who are not suitable for the prone position.


JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119


2021 ◽  
Vol 42 (4) ◽  
pp. 102977
Author(s):  
Alexander N. Goel ◽  
Andrey Filimonov ◽  
Julie Teruya-Feldstein ◽  
Christian Salib ◽  
Joseph J. Rousso ◽  
...  

2021 ◽  
pp. 201010582110310
Author(s):  
Ernest Weisheng Ho ◽  
Eng Leonard ◽  
Lee Tih-Shih ◽  
Gregory James Meredith

Electroconvulsive therapy (ECT) is effective for mood disorders and schizophrenia. Thermal burns, while rare, are potentially sight and life threatening. The three elements necessary for a fire are often in close proximity during a session: an oxidiser (oxygen), an ignition source (faulty electrodes, poor contact with skin producing a spark) and fuel (hair, residual alcohol cleanser). This case report describes one such incident when a patient sustained a burn during ECT, with poor contact of electrode pad with skin, high impedance and an oxygen-rich environment possibly contributing. Given that ECT is conducted relatively frequently (once every 2–3 days) in a usual regimen, we make recommendations for safe application of electrode pads for temporal placement ECT.


2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.


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