Intrapleural t-PA therapy for loculated pleural effusion arising after percutaneous nephrolithotripsy: a case report.
Pleural complications from upper pole percutaneous renal access for lithotripsy occur infrequently and are managed minimally invasively with urinary diversion (double-J stent or nephrostomy) and chest tube placement. However, sometimes the pleural effusion may evolve into an empyema that requires open or thoracoscopic decortication. We present a novel approach in which topical fibrinolytic therapy was used to successfully resolve a symptomatic, nonresolving (despite antibiotic treatment and a properly positioned chest tube), loculated pleural effusion arising post percutaneous nephrolithotripsy.
Urology Service, James A. Haley VAMC, Tampa, FL 33612, USA. Fernando.coste-delvecchio@va.gov
Fernando C
FC
Delvecchio
Mary K
MK
Hall
Steven
S
Farber
D000368:Aged; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D011859:Radiography; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator