Pitfalls of subcapsular nephrectomy: report of a case with point of technique to avoid urinary fistula formation

J Postgrad Med. 2010 Jan-Mar;56(1):24-6. doi: 10.4103/0022-3859.62433.

Abstract

Nephrectomy after pyonephrosis, repeated acute pyelonephritis or chronic pyelonephritis is a challenge for any surgeon, owing to adhesions around the kidney. We encountered an unusual case of post-nephrectomy urinary fistula, as a complication of subcapsular nephrectomy. This occurred as a result of residual renal tissue after nephrectomy, which was subsequently excised using methylene blue as an aid to ensure complete excision. Such a complication has never been reported in existing literature. We reviewed the literature for any such related complications to gather an insight to its occurrence and also present a simple point of technique to avoid such a catastrophe.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Coloring Agents
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / pathology
  • Kidney Failure, Chronic / surgery*
  • Male
  • Methylene Blue
  • Nephrectomy / adverse effects*
  • Nephrectomy / methods
  • Pyelonephritis / complications
  • Pyelonephritis / pathology
  • Pyelonephritis / surgery*
  • Tissue Adhesions
  • Treatment Outcome
  • Urinary Fistula / etiology*
  • Urinary Fistula / prevention & control
  • Urinary Fistula / surgery

Substances

  • Coloring Agents
  • Methylene Blue