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Case Reports
. 2016 Nov 1;2(1):224-226.
doi: 10.1089/cren.2016.0108. eCollection 2016.

Reperfusion and Compartment Syndrome After Flexible Ureteroscopy in a Patient with an Iliac Vascular Graft

Esteban Emiliani  1 , Michele Talso  2 , Edgar Beltrán-Suárez  2 , Steeve Doizi  1 , Olivier Traxer  1
Affiliations
Case Reports

Reperfusion and Compartment Syndrome After Flexible Ureteroscopy in a Patient with an Iliac Vascular Graft

Esteban Emiliani et al. J Endourol Case Rep. .

Abstract

Background: Flexible ureteroscopy (fURS) is one of the main treatment options for urolithiasis less than 2 cm. Although fURS has no relative contraindication, some anatomical factors may need to be considered, as not all patients are suitable for the regular lithotomy position (LP). We report the case of a patient with a right iliac vascular graft that after an fURS without intraoperative incidences developed a reperfusion syndrome of the right lower limb. Case Presentation: A 46-year-old male patient was referred for treatment and follow-up in the cystinuric clinic after being found to have a 3 cm pelvic stone with a Double-J catheter in place after two failed sessions of shockwave lithotripsy. The patient was placed in the LP and a standard ureteroscopy was done with no intraoperative complications. During the first hour in the recovery room, the patient developed severe pain in the right calf muscle stiffness, edema, and increased volume. A postreperfusion and compartment syndrome diagnosis was made with emergency fasciotomy. Conclusion: To perform fURS, each case must be assessed individually. If a patient with an iliac vascular graft has to undergo fURS, the patient positioning must be modified by keeping the ipsilateral (or both) legs straight to avoid graft complications.

Keywords: complications; lithotomy; position; ureteroscopy; vascular.

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Conflict of interest statement

Statement No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
(a) Lithotomy position. (b) Modified lithotomy position with leg extended on the graft side. (c) Dorsal supine.
See this image and copyright information in PMC

References

    1. Türk C, Petřík A, Sarica K, et al. . EAU Guidelines on interventional treatment for urolithiasis. Eur Urol 2016;69:475–482 - PubMed
    1. De la Rosette J, Denstedt J, Geavlete P, et al. ; CROES URS Study Group. The clinical research office of the endourological society ureteroscopy global study: Indications, complications, and outcomes in 11,885 patients. J Endourol 2014;28:131–139 - PubMed
    1. Giusti G, Proietti S, Villa L, et al. . Current standard technique for modern flexible ureteroscopy: Tips and tricks. Eur Urol 2016;70:188–194 - PubMed
    1. Mandal S, Goel A, Singh MK, et al. . Clavien classification of semirigid ureteroscopy complications: A prospective study. Urology 2012;80:995–1001 - PubMed
    1. Cindolo L, Castellan P, Scoffone CM, et al. . Mortality and flexible ureteroscopy: Analysis of six cases. World J Urol 2016;34:305–310 - PubMed

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