Acute delayed onset hemodynamic and respiratory compromise due to thoracic translocation of hemourinoma after percutaneous nephrolithotomy()

Percutaneous nephrolithotomy (PCNL) despite its minimally invasive approach has an high complication rate, with the most common complications being extravasation of urine and perioperative bleeding requiring transfusion. While most of these complications are minor, many serious and life-threatening complications do occur. One such complication is the development of hemothorax or hydrothorax which usually develops in the early postoperative period with blood or urine passing from the surgical site through a newly established pleural-peritoneal fistula. Here we describe an unusual presentation and clinical management of delayed onset acute urohemothorax and hemodynamic collapse several days following PCNL.