Splenic injury during percutaneous nephrolithotomy.
BACKGROUND
Injury to the spleen is a recognized complication during percutaneous renal access due to the close anatomical relationship of the spleen and the left kidney. However, transsplenic renal access is a rare complication of percutaneous nephrolithotomy and can also result in considerable morbidity, often requiring emergent splenectomy.


METHODS
We present our experience with splenic injury during percutaneous nephrolithotomy managed conservatively with the use of a collagen-thrombin hemostatic sealant (D-Stat; Vascular Solutions, Inc., Minneapolis, MN) after delayed removal of the nephrostomy tubes.


RESULTS
The patient had an uneventful recovery and was discharged home on postoperative day 6.


CONCLUSIONS
In select hemodynamically stable patients, nonoperative management with the adjunctive use of hemostatic sealants may be considered.
Thomas
Anil A
AA
Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Pierce
Gregory
G
Walsh
R Matthew
RM
Sands
Mark
M
Noble
Mark
M
D000328:Adult; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D015641:Radiography, Interventional; D013154:Spleen / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics