Incidental Finding of Intrarenal Foreign Guidewire During Percutaneous Nephrolithotomy: A Case Report and Literature Review

Patient: Male, 54-year-old Final Diagnosis: Foreign body in the abdominal cavity Symptoms: Flank pain Clinical Procedure: — Specialty: Urology OBJECTIVE: Challenging differential diagnosis BACKGROUND: Percutaneous nephrolithotomy (PCNL) is indicated for large renal calculi (³2 cm) and is often the t...

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Autores principales: Xiong, Lin, Kwan, Kristine J.S., Hou, Jian, Lu, Zhen-Quan, Wei, Geng-Geng, Xu, Xiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246727/
https://www.ncbi.nlm.nih.gov/pubmed/37270666
http://dx.doi.org/10.12659/AJCR.939700
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author Xiong, Lin
Kwan, Kristine J.S.
Hou, Jian
Lu, Zhen-Quan
Wei, Geng-Geng
Xu, Xiang
author_facet Xiong, Lin
Kwan, Kristine J.S.
Hou, Jian
Lu, Zhen-Quan
Wei, Geng-Geng
Xu, Xiang
author_sort Xiong, Lin
collection PubMed
description Patient: Male, 54-year-old Final Diagnosis: Foreign body in the abdominal cavity Symptoms: Flank pain Clinical Procedure: — Specialty: Urology OBJECTIVE: Challenging differential diagnosis BACKGROUND: Percutaneous nephrolithotomy (PCNL) is indicated for large renal calculi (³2 cm) and is often the treatment of choice due to its high success rate. Guidewire fragmentation is a rare procedural accident that can occur in PCNL but may be missed. Retention of the fragment within the upper urinary tract can lead to further complications, such as recurrent nephrolithiasis or impairment of renal function. CASE REPORT: We present the case of a 54-year-old man who experienced right flank pain for 5 days. His history was significant for recurrent nephrolithiasis, managed by PCNL in other hospitals. The most recent procedure was conducted 4 years ago, and his perioperative course was uneventful. Preoperative computed tomography revealed right renal calculi and a C-shaped foreign body. He was scheduled for an elective PCNL. The foreign body was intraoperatively identified as a guidewire fragment and removed. CONCLUSIONS: Currently, there is no standard management for intrarenal foreign bodies. Suspicion should be raised in young patients with recurrent stones within a short period of time. A thorough history on past urological interventions should be obtained. Symptoms can also have an insidious onset that could mimic nephrolithiasis or uri-nary tract infections. Extraction can be done via a standard minimally invasive approach. It is also the surgeon’s responsibility to check the integrity of intraoperative instruments so as to minimize risks of complication and reassure the patient.
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spelling pubmed-102467272023-06-08 Incidental Finding of Intrarenal Foreign Guidewire During Percutaneous Nephrolithotomy: A Case Report and Literature Review Xiong, Lin Kwan, Kristine J.S. Hou, Jian Lu, Zhen-Quan Wei, Geng-Geng Xu, Xiang Am J Case Rep Articles Patient: Male, 54-year-old Final Diagnosis: Foreign body in the abdominal cavity Symptoms: Flank pain Clinical Procedure: — Specialty: Urology OBJECTIVE: Challenging differential diagnosis BACKGROUND: Percutaneous nephrolithotomy (PCNL) is indicated for large renal calculi (³2 cm) and is often the treatment of choice due to its high success rate. Guidewire fragmentation is a rare procedural accident that can occur in PCNL but may be missed. Retention of the fragment within the upper urinary tract can lead to further complications, such as recurrent nephrolithiasis or impairment of renal function. CASE REPORT: We present the case of a 54-year-old man who experienced right flank pain for 5 days. His history was significant for recurrent nephrolithiasis, managed by PCNL in other hospitals. The most recent procedure was conducted 4 years ago, and his perioperative course was uneventful. Preoperative computed tomography revealed right renal calculi and a C-shaped foreign body. He was scheduled for an elective PCNL. The foreign body was intraoperatively identified as a guidewire fragment and removed. CONCLUSIONS: Currently, there is no standard management for intrarenal foreign bodies. Suspicion should be raised in young patients with recurrent stones within a short period of time. A thorough history on past urological interventions should be obtained. Symptoms can also have an insidious onset that could mimic nephrolithiasis or uri-nary tract infections. Extraction can be done via a standard minimally invasive approach. It is also the surgeon’s responsibility to check the integrity of intraoperative instruments so as to minimize risks of complication and reassure the patient. International Scientific Literature, Inc. 2023-06-04 /pmc/articles/PMC10246727/ /pubmed/37270666 http://dx.doi.org/10.12659/AJCR.939700 Text en © Am J Case Rep, 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Xiong, Lin
Kwan, Kristine J.S.
Hou, Jian
Lu, Zhen-Quan
Wei, Geng-Geng
Xu, Xiang
Incidental Finding of Intrarenal Foreign Guidewire During Percutaneous Nephrolithotomy: A Case Report and Literature Review
title Incidental Finding of Intrarenal Foreign Guidewire During Percutaneous Nephrolithotomy: A Case Report and Literature Review
title_full Incidental Finding of Intrarenal Foreign Guidewire During Percutaneous Nephrolithotomy: A Case Report and Literature Review
title_fullStr Incidental Finding of Intrarenal Foreign Guidewire During Percutaneous Nephrolithotomy: A Case Report and Literature Review
title_full_unstemmed Incidental Finding of Intrarenal Foreign Guidewire During Percutaneous Nephrolithotomy: A Case Report and Literature Review
title_short Incidental Finding of Intrarenal Foreign Guidewire During Percutaneous Nephrolithotomy: A Case Report and Literature Review
title_sort incidental finding of intrarenal foreign guidewire during percutaneous nephrolithotomy: a case report and literature review
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246727/
https://www.ncbi.nlm.nih.gov/pubmed/37270666
http://dx.doi.org/10.12659/AJCR.939700
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