title: A nephropleural fistula complicated by distal ureteral obstruction results in tension hydrothorax after percutaneous nephrostolithotomy.
abstract: We present the case of a patient with nephrocalcinosis and chronic kidney disease who underwent percutaneous nephrostolithotomy via a mid-pole access. After nephroureteral stent removal, the patient developed a tension hydrothorax due to the rare combination of a nephropleural fistula and ipsilateral distal ureteral obstruction. This complication was managed by percutaneous nephrostomy and thoracostomy placement and subsequent thoracoscopic surgery without further sequelae.
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, TX.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Scovell
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, TX. Electronic address: link@bcm.edu.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Link
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D006876:Hydrothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D013902:Radiography, Thoracic / Q000379:methods; D035583:Rare Diseases; D016156:Respiratory Tract Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D018570:Risk Assessment; D012720:Severity of Illness Index; D013907:Thoracostomy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D055815:Young Adult