title: Splenic injury during percutaneous nephrolithotomy.
abstract: 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.
authors: Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors: Anil A
authors: AA
authors: Thomas
authors: Gregory
authors: G
authors: Pierce
authors: R Matthew
authors: RM
authors: Walsh
authors: Mark
authors: M
authors: Sands
authors: Mark
authors: M
authors: Noble
mesh_terms: 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
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics