• Journal of Trauma and Injury
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• 제32권2호
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• pp.118-121
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• 2019

Percutaneous nephrostomy is relatively safe for temporary urinary diversion. However, colonic perforation due to percutaneous nephrostomy can happen with an incidence of 0.2% as reported in the English literatures. To our knowledge, this is the first case being reported as a complication following treatment for traumatic renal injury. This paper is to share our treatment approach which differs from the usual approach according to existing literatures. We report on a young man who sustained grade IV renal injury due to blunt trauma and was managed conservatively. The treatment of traumatic renal injury via urinary diversion was complicated with an iatrogenic colonic perforation. The management and subsequent treatment of this patient is discussed in this case report.

• Journal of Yeungnam Medical Science
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• 제15권1호
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• pp.159-163
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• 1998

영남대학교 의과대학 부속병원에서 1995년 3월부터 1997년 6월까지 수신증이 있는 58명의 환자, 98례에서 초음파 유도하에 18게이지 천자침으로 직접 신배를 천자하여 경피신루설치술을 시술하였다. 수신증의 원인은 악성 종양에 의한 협착이 65례였으며 이 중 자궁경부암이 가장 많았으며 양성 협착은 25례로 결석, 결핵, 수술에 의한 요관 손상 등의 순위였고, 원인을 알 수 없는 협착이 8례 있었다. 전 예에서 성공적으로 경피신루를 설치하였다. 시술의 합병증은 7.1%로 기존의 21게이지 세침을 이용한 시술과 비슷하였다. 저자들이 시술한 18게이지 천자침을 이용한 경피신루설치술은 21게이지 세침으로 천자하고 0.018인치 유도 철사와 외피가 있는 19게이지 도관을 사용하는 기존의 시술에 비해 시술의 단계를 간략화하여 시간과 비용을 줄일 수 있을 뿐 아니라 합병증의 발생빈도가 높지 않은 안전한 시술로써 유소아나 수신증이 아주 경미한 경우 등을 제외한 수신증에서 기존의 시술을 대치 할 수 있을 것으로 생각된다.

• Journal of Medicine and Life Science
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• 제19권2호
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• pp.66-69
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• 2022

Patients with vesicoureteral reflux (VUR), the retrograde flow of urine from the bladder to the kidney, are known to experience renal scarring; this results in the worsening of renal function. Reflux nephropathy is a cause of chronic kidney disease, and VUR has also been observed in dialysis patients. VUR is a major underlying precursor condition of urinary tract infection (UTI) and is sometimes accompanied by hydronephrosis. However, there are no guidelines for the management of UTI due to VUR-associated hydronephrosis in patients with end-stage kidney disease. Herein, we report a case of UTI caused by VUR-associated hydronephrosis in a dialysis patient treated with percutaneous nephrostomy.

• Investigative and Clinical Urology
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• 제59권6호
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• pp.371-375
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• 2018

Purpose: To compare patients with sepsis due to obstructive urolithiasis (Sep-OU) and underwent drainage by percutaneous nephrostomy (PCN) or a double-J (DJ)-ureteral stent and to identify predictive risk factors of DJ stent failure in these patients. Materials and Methods: We reviewed our records from January 2013 to July 2018 and identified 286 adult patients with Sep-OU out of which 36 had bilateral involvement, thus total 322 renal units were studied. Urologic residents in training carried out both ureteral stenting and PCN tube placement. Demographic data and stone characteristics were recorded along with Charlson comorbidity index. For predicting risk factors of DJ stent failure, those variables that had a p-value <0.1 in univariate analysis were combined in a multinomial regression analysis model. Results: The patients with PCN placement were significantly older than those with DJ stent placement (p=0.001) and also had significant number of units with multiple calculi (p=0.018). PCN was also placed more frequently in those patients with a upper ureteric calculi (p<0.05). On multinomial regression analysis multiple calculi (p=0.014; odds ratio [OR], 4.878; 95% confidence interval [CI], 1.377-17.276) and larger calculi size (p=0.040; OR, 0.974; 95% CI, 0.950-0.999) were the significant predictors of DJ stent failure. Conclusions: In patients with sepsis from obstructive urolithiasis due to larger and multiple calculi a PCN placement might be better suited although this data requires further prospective randomized studies to be extrapolated.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.47-50
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• 2017

A 21-year-old male visited our emergency room. He could not remember the mechanism of injury. He was found beside a motorcycle. Initial vital sign was stable. Observation and conservative treatment were planned at the intensive care unit (ICU). On the third day at ICU, he complained sudden flank pain. It was colicky and hard to control. Without the pain, he had no specific symptom, sign, or laboratory findings. On computed tomography, renal pelvis was filled with hematoma which induced hydronephrosis. Double-J catheter and percutaneous nephrostomy was implemented by an intervention radiologist. Hematome in the renal pelvis was aspirated during the procedure. Symptom of the patient was subsided after the procedure. He was discharged without specific complications.