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. 2013 Jun;17(2):90-2.
doi: 10.5213/inj.2013.17.2.90. Epub 2013 Jun 30.

Migration of a Hem-o-Lok Clip to the Ureter Following Laparoscopic Partial Nephrectomy Presenting With Lower Urinary Tract Symptoms

Kyung Seo Park  1 , Young Jin Sim, Han Jung
Affiliations

Migration of a Hem-o-Lok Clip to the Ureter Following Laparoscopic Partial Nephrectomy Presenting With Lower Urinary Tract Symptoms

Kyung Seo Park et al. Int Neurourol J. 2013 Jun.

Abstract

We report a case of ureteral migration of a surgical clip after partial nephrectomy in which the clip was misdiagnosed as a ureteral stone. A 37-year-old woman had undergone laparoscopic partial nephrectomy of right renal cell carcinoma at another hospital 2 years previously. Postoperatively, she had gradually acquired lower urinary tract symptoms. Then, she complained of sudden right flank pain for a week. A plain X-ray and enhanced abdominopelvic computed tomography scan were performed. A 0.5 cm×1.0 cm right upper ureteral opacity with borderline hydronephrosis was seen but could not be found on the X-ray. Ureteroscopy revealed a medium-sized Hem-o-Lok clip on the right upper ureter that was removed with a stone basket. We concluded that a Hem-o-Lok clip used for collecting system sealing had migrated to the ureter and had been misdiagnosed as a ureteral stone on a computed tomography scan.

Keywords: Nephrectomy; Surgical instruments; Ureteral calculi.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Plain X-ray of the abdomen revealed metallic surgical clips on the right upper abdomen and a possible right renal stone but no abnormal density on the ureteral courses. KUB, kidney-ureter-bladder.
Fig. 2
Fig. 2
abdominopelvic computed tomography scan revealed a 0.5 cm×1.0 cm opacity (arrow) on the right proximal ureter.
Fig. 3
Fig. 3
(A) Ureteroscopy showed a white rectangular parallelepiped foreign body at the proximal right ureter. (B) The foreign body was removed by use of a ureteroscopic stone basket device and was identified as a medium-sized Hem-o-Lok Clip.
See this image and copyright information in PMC

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