title: Colon perforation during percutaneous nephrolithotomy and fistula closure with Spongostan following conservative therapy.
abstract: Percutaneous nephrolithotomy (PCNL) is the first-line treatment for kidney stones. Colon perforation is a rare, but dangerous, complication. Colonic perforation might be very serious if it is not found early. After an unsuccessful extracorporeal shockwave lithotripsy, a 45-year-old female underwent a left-sided PCNL for two 1-cm kidney stones in the left kidney upper pole calyx. During dilatation, a colon perforation was suspected. The procedure was finished by inserting a 14Fr re-entry catheter into the colon. On postoperative day 5, a fluoroscopy was performed by injecting contrast dye through the re-entry catheter, which showed a fistula formation between skin and colon. The catheter was removed completely. A 16Fr external drainage catheter was inserted over the guide-wire through the fistula tract. The fistula was closed by introducing prepared absorbable hemostatic gelatin powder (Spongostan) particles into the fistula tract through the catheter. Fistula tracks can be closed early by injecting absorbable Spongostan particles into the colonic fistula tract, thereby reducing inpatient time and increasing patient comfort.
authors.affiliation: Department of Urology, İzmir Katip Çelebi University, Atatürk Research and Training Hospital, Karabağlar/İzmir, Turkey;
authors.forename: Sıtkı
authors.initials: S
authors.lastname: Ün
authors.affiliation: Department of Radiology, İzmir Katip Çelebi University, Atatürk Research and Training Hospital, Karabağlar/İzmir, Turkey;
authors.forename: Volkan
authors.initials: V
authors.lastname: Çakır
authors.affiliation: Department of Urology, İzmir Katip Çelebi University, Atatürk Research and Training Hospital, Karabağlar/İzmir, Turkey;
authors.forename: Osman
authors.initials: O
authors.lastname: Köse
authors.affiliation: Department of Urology, İzmir Tepecik Research and Training Hospital, Konak/İzmir, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Türk
authors.affiliation: Department of Urology, İzmir Katip Çelebi University, Atatürk Research and Training Hospital, Karabağlar/İzmir, Turkey;
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Yılmaz