"Clip-strasse": A novel complication following partial nephrectomy.
This report presents the case of a 63-year-old man who presented with recurrent visible haematuria and loin pain 18 months after open partial nephrectomy for renal cell carcinoma. A computed tomography urogram revealed three obstructing calculi in the mid- to distal ureter with hydronephrosis. Rigid ureteroscopy revealed three calcified objects in the pelvic ureter. These had the appearance of calcified Weck® clips. A laser was used to remove the calcification, confirming the presence of three Weck clips, which had been used for haemostasis during the partial nephrectomy. These were removed with graspers after balloon dilatation of the distal ureter. This phenomenon of multiple clips migrating with stone formation and obstruction of the ureter was named "clip-strasse".
a 1 Department of Urology, James Cook University Hospital , Middlesbrough, UK.
Andrew C
AC
Bayles
a 1 Department of Urology, James Cook University Hospital , Middlesbrough, UK.
Aftab
A
Bhatti
a 1 Department of Urology, James Cook University Hospital , Middlesbrough, UK.
Ashok
A
Sakthivel
b 2 Department of Radiology, James Cook University Hospital , Middlesbrough, UK.
Geoffrey
G
Naisby
a 1 Department of Urology, James Cook University Hospital , Middlesbrough, UK.
Basavaraj
B
Gowda
D002292:Carcinoma, Renal Cell / Q000601:surgery; D005547:Foreign Bodies / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D017699:Pelvic Pain / Q000209:etiology; D011183:Postoperative Complications / Q000601:surgery; D013525:Surgical Instruments / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014514:Ureteral Calculi / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D018666:Ureteroscopy
Complications; nephrectomy; partial