Sudden onset of a huge subcapsular renal hematoma following minimally invasive ureteroscopic holmium laser lithotripsy: A case report

Abstract

The postoperative complication rate of ureteroscopic lithotripsy (URSL) is low, and the most frequent complication is fever. Thus, urological surgeons often neglect or are unaware of subcapsular renal hematoma (SRH) as a rare complication following URSL. Although a SRH after undergoing URSL is uncommon, the occurrence may be fatal. The current study reports on a rare life-threatening case that occurred recently at Zhongnan Hospital (Wuhan, China). A 24-year-old male patient presented with a large SRH (11×14×11 cm) after undergoing a failed, but minimally invasive URSL with a holmium laser. The presence of the large SRH was confirmed by computerized tomography imaging. The patient underwent conservative management, which prevented hematoma enlargement, and no further treatment was conducted. In conclusion, SRH, although rare following URSL, should be noted by the urological surgeon.

Keywords: conservative management; subcapsular renal hematoma; ureteral calculus; ureterorenoscopy.

Figure 1.

Images captured at the original presentation. Contrast-enhanced computerized tomography scans show (A) moderate left hydronephrosis and (B) two calculi in the left proximal ureter (arrow).

Figure 2.

Images captured 36 h after the original presentation. Computerized tomography scans demonstrate (A and B) a huge subcapsular hematoma of the left kidney and (B) the stone in the renal pelvis from the left proximal ureter (arrow).