Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9623-9628
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9623
Bilateral hematoma after tubeless percutaneous nephrolithotomy for unilateral horseshoe kidney stones: A case report
Cheng Zhou, Ze-Jun Yan, Yue Cheng, Jun-Hui Jiang
Cheng Zhou, Ze-Jun Yan, Yue Cheng, Jun-Hui Jiang, Department of Urology, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo 315000, Zhejiang Province, China
Author contributions: Zhou C contributed design and drafting of the article, and final approval of the version to be submitted; Yan ZJ contributed data acquisition, drafting of the article, and final approval of the version to be submitted; Cheng YC contributed data acquisition, critical revision of the article, and final approval of the version to be submitted; Jiang JH contributed critical revision of the article, and final approval of the version to be submitted.
Supported by Medical Health Science and Technology Project of Zhejiang Provincial Health Commission, No. 2019KY575 (to Zhou C).
Informed consent statement: This case report was approved by the institutional ethical committee in our hospital, and written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Hui Jiang, MCh, Director, Executive Vice President, Department of Urology, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, No. 59 Liuting Street, Ningbo 315000, Zhejiang Province, China. 215606239@qq.com
Received: May 6, 2021
Peer-review started: May 6, 2021
First decision: July 5, 2021
Revised: July 11, 2021
Accepted: September 8, 2021
Article in press: September 8, 2021
Published online: November 6, 2021
Processing time: 176 Days and 0.7 Hours
Abstract
BACKGROUND

Bilateral perirenal hematoma is rarely reported in endoscopic management of horseshoe kidney stones, and there are few studies reporting the formation of bilateral hematoma following tubeless percutaneous nephrolithotomy (PCNL) for unilateral horseshoe kidney calculi.

CASE SUMMARY

A 32-year-old man was admitted to our hospital because of repeated intermittent hematuria for 10 years. Plain abdominal computed tomography (CT) scan revealed calculi in the horseshoe kidney; the largest being 2 cm in diameter. Tubeless PCNL was performed to remove the stones. Three days after the operation, the patient was discharged in a stable situation. Three days after discharge, the patient presented to our emergency department because of right low back pain and vomiting. Emergent CT scan revealed subcapsular and perirenal hematocele and exudates in both kidneys. Ultrasound-guided puncture and drainage of perirenal effusion were performed. After the temperature stabilized, the patient received low-pressure injection of urokinase 100000 U for 3 d. His routine blood indexes and the renal function returned to normal in 3 wk. CT re-examination 3 mo after lithotripsy showed that the subcapsular and perirenal hematoma and exudates in both kidneys were significantly absorbed as compared with those before. The patient was followed up for 1 year, during which no flank pain or hematuria recurred.

CONCLUSION

This is the first case report on the formation of bilateral hematoma following tubeless PCNL for unilateral horseshoe kidney calculi.

Keywords: Horseshoe kidney; Kidney calculi; Tubeless percutaneous nephrolithotomy; Urokinase; Case report

Core Tip: Minimally invasive urological techniques, such as retrograde intrarenal surgery, percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy, have been applied for the treatment of horseshoe kidney stones, but they all have their respective advantages and disadvantages in terms of efficacy and postoperative complications. To the best of our knowledge, there is no study reporting the formation of bilateral hematoma following tubeless PCNL for unilateral horseshoe kidney calculi. Our experience in treating this patient can be summarized as six points, which are a good reference for readers.