Computed tomographic evaluation and guided correction of malpositioned nephrostomy catheters.
BACKGROUND
To determine the utility of computed tomography (CT) in the detection and correction of malpositioned nephrostomy catheters after contrast spillage during nephrostograms.


METHODS
CT was performed in nine patients after an abnormal (contrast spillage) tube nephrostogram performed during or after nephrostomy tube placement. CT was used to locate the nephrostomy catheter position in relation to the renal collecting system. If possible, CT was also used for guidance and repositioning of the nephrostomy catheters into the intrarenal collecting system.


RESULTS
In all nine cases, CT was successful in detecting the position of the suspected malpositioned catheter. In seven of nine cases, CT demonstrated the catheter outside the renal collecting system and effectively helped reposition the catheters into the intrarenal collecting system. In one case, the malpositioned nephrostomy catheter was within the intraperitoneal cavity and required surgical correction. Another case required fluoroscopic-guided repositioning for the initial nephrostomy catheter, which was partly posterior to the kidney and partly within the kidney. The catheter in this latter case was successfully advanced over a guidewire into the collecting system.


CONCLUSIONS
CT may be used to detect possible catheter malposition associated with nephrostomy tube placement. CT may also be used to successfully guide catheter repositioning in the renal collecting system.
Jones
C D
CD
Department of Radiology, University of California Medical Center, Davis, Ambulatory Care Center, 4860 Y Street, Suite 3100, Sacramento, CA 95817, USA.
McGahan
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed
D003287:Contrast Media