Incidentalni neadekvatni plasman perkutanog nefrostomskog katetera u venu kavu inferior
Sažetak
Uvod. Izolovana ruptura pijelokaliksnog sistema je redak tip tupe traume tog sistema koja se može pojaviti kod bolesnika sa preegzistentnom hidronefozom izazvanom različitim uzrocima. Prikazali smo bolesnicu sa preegzistentnom hidronefrozom izazvanom postiradijacionom stenozom uretera sa neadekvatnim plasmanom nefrostomskog katetera prilikom tretmana izolovane rupture pijelokaliksnog sistema. Prikaz bolesnika. Bolesnica, stara 36 godina, upućena je u našu instituciju od strane ginekologa radi lečenja retroperitonealnog urinoma. Godinu dana ranije završena je kombinovana zračna terapija i primena hemioterapije cisplatinom zbog ginekološkog maligniteta. Kompijuterizovanom tomografijom utvrđena je izolovana ruptura pijelokaliksnog sistema levog bubrega sa preegzistentnom hidronefrozom. Nefrostomski kateter je nehotično plasiran u venu kavu inferior prilikom pokušaja preliminarne perkutane drenaže. Bolesnici je urađena laparotomija, sutura pijelokaliksnog sistema i ureterocistoneostomija sa postavljanjem dvostrukog pigtail katetera. Nefrostomski kateter je uklonjen u toku iste procedure. Zaključak. Incidentalna povreda vaskularnih struktura je moguća kod ultrazučno vođenog plasmana nefrostomskog katetera. Navedena komplikacija bi možda bila izbegnuta da je dilatacija nefrostomskog trakta preko žice vodilje rađena pod kontrastnom radiološkom fluoroskopijom.
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