Coexisting pseudoaneurysm and arteriovenous fistula following percutaneous nephrolithotomy

Abstract

Abstract Percutaneous Nephrolithotomy (PCNL) is a common and safe treatment for large kidney stones.Though several complications are reported.Renal hemorrhage is the most common complication after PCNL with a incidence of 11.2% to 17.5%.There have been reports of post PCNL bleeding attributable to AV fistulas and pseudoaneurysms. Massive bleeding can occur in the early postoperative period (2 to 14 days after PCNL), and arteriovenous fistula formation as a late complication usually 6 weeks after PCNL. A 45 yrs old gentleman presented with bilateral flank pain,right sided prone PCNL done. Then presented with post PCNL hematuria, angioemblosation done twice but again developed hematuria and diagnostic angiography done, and diagnosed as A-V fistula and coiling done. No post operative complications were seen. Angiography is the preferred method and has advantages as it can detect vascular lesions and immediately treated once they are detected.Early diagnosis and treatment of post PCNL hematuria is warrented to reduce morbidity and a successful outcome.