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. 2020 Sep 17;6(3):241-243.
doi: 10.1089/cren.2020.0004. eCollection 2020.

Arteriocaliceal Fistula: A Life-Threatening Condition After Retrograde Intrarenal Surgery

João Rafael Silva Simões Estrela  1 , Alexandre Azevedo Ziomkowski  1 , Breno Dauster  1 , André Costa Matos  1
Affiliations

Arteriocaliceal Fistula: A Life-Threatening Condition After Retrograde Intrarenal Surgery

João Rafael Silva Simões Estrela et al. J Endourol Case Rep. .

Abstract

Background: Retrograde intrarenal surgery (RIRS) has emerged as a viable and safe option for renal stones <2 cm. Because of its high efficiency and relative safety, experienced endourologists have applied it to even larger stones. We present a case of arteriocaliceal fistula, which is a rare postoperative complication of RIRS. Case Presentation: A 52-year-old man with a rich history of endourologic procedures and extracorporeal shockwave lithotripsy caused by inferior caliceal calculi was subjected to RIRS. This was complicated by transient intraoperative hemorrhage, followed by recurrent hematuria and clot retention several days postoperatively. Renal arteriography revealed the presence of an arteriocaliceal fistula. This was completely resolved with selective arterial embolization. Conclusion: This case highlights that early detection and timely intervention are crucial to avoid serious consequences of post-RIRS hemorrhage resulting from arteriocaliceal fistula.

Keywords: endourology; nephrolithiasis; retrograde intrarenal surgery; surgical complication; urology.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Left kidney lower pole stone.
FIG. 2.
FIG. 2.
Arteriography showing arteriocaliceal fistula followed by ultraselective embolization with spring.
See this image and copyright information in PMC

References

    1. Türk C, Petřík A, Sarica K, et al. . EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 2016;69:468–474 - PubMed
    1. Somani BK, Giusti G, Sun Y, et al. . Complications associated with ureterorenoscopy (URS) related to treatment of urolithiasis: The Clinical Research Office of Endourological Society URS Global study. World J Urol 2017;35:675–681 - PMC - PubMed
    1. Cindolo L, Castellan P, Primiceri G, et al. . Life-threatening complications after ureteroscopy for urinary stones: Survey and systematic literature review. Minerva Urol Nefrol 2017;69:421–431 - PubMed
    1. Cindolo L, Castellan P, Marco C, et al. . Mortality and flexible ureteroscopy: Analysis of six cases 2015. World J Urol 2016;34:305–310 - PubMed

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