title: Intraparenchymal hematoma as a late complication of retrograde intrarenal surgery.
abstract: A 34 year-old woman was admitted to our hospital with left flank pain. A non-contrast enhanced computerized tomography (NCCT) revealed a 1.5x2cm left proximal ureter stone. Patient was scheduled for ureterorenoscopy (URS) and stone removal. She was submitted to retrograde intrarenal surgery (RIRS). At the postoperative 1st day, the patient began to suffer from left flank pain. A NCCT was taken, which revealed a subcapsular hematoma and perirenal fluid. The patient was managed conservatively with intravenous fluid, antibiotic and non-steroidal anti-inflammatory drug therapy and was discharged at the postoperative 6th day. Two weeks after the discharge the patient was admitted to emergency department with severe left flank pain, palpitation and malaise. KUB (kidney-ureter-bladder) radiography showed double-J stent (DJS) to be repositioned to the proximal ureter. Patient was evaluated with contrast enhanced CT which revealed an 8cm intraparenchymal hematoma/abscess in the middle part of the kidney. A percutaneous drainage catheter was inserted into the collection. The percutaneous drainage catheter and the DJS were removed at the 10th day of second hospitalization. RIRS surgery is an effective and feasible choice for renal stones with high success and acceptable complication rates. However, clinician should be alert to possible complications.
authors.affiliation: Turkey Yuksek Ihtisas Training and Research Hospital, Urology Clinic, Ankara, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Yahsi
authors.affiliation: Turkey Yuksek Ihtisas Training and Research Hospital, Urology Clinic, Ankara, Turkey.
authors.forename: Senol
authors.initials: S
authors.lastname: Tonyali
authors.affiliation: Turkey Yuksek Ihtisas Training and Research Hospital, Urology Clinic, Ankara, Turkey.
authors.forename: Cavit
authors.initials: C
authors.lastname: Ceylan
authors.affiliation: Turkey Yuksek Ihtisas Training and Research Hospital, Urology Clinic, Ankara, Turkey.
authors.forename: Kenan Y
authors.initials: KY
authors.lastname: Yildiz
authors.affiliation: Turkey Yuksek Ihtisas Training and Research Hospital, Urology Clinic, Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Ozdal
mesh_terms: D000328:Adult; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D000072356:Parenchymal Tissue / Q000000981:diagnostic imaging / Q000293:injuries*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011312:Pressure; D015607:Stents / Q000009:adverse effects; D053039:Ureterolithiasis / Q000150:complications / Q000601:surgery*; D020709:Ureteroscopes / Q000009:adverse effects*; D018666:Ureteroscopy / Q000009:adverse effects*
keywords: Intrarenal Surgery; computed tomography; urolithiasis 