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العنوان
Subcapsular renal hematoma in patients underwent upper ureteroscopic lithotripsy \
المؤلف
Saleh,Ismail Mahdy.
هيئة الاعداد
باحث / إسماعيل مهدي صالح
مشرف / أ.د/ يوســف محمــــود قطــب
مشرف / د/ محمد قنديل عبد الفتاح
مشرف / د/ محمد قنديل عبد الفتاح
تاريخ النشر
2019.
عدد الصفحات
156 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
جراحة المسالك البولية
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - جراحة المسالك البولية
الفهرس
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Abstract

Objective: to demonstrate the risk factors of developing subcapsular renal hematoma
( SRH) in patients who underwent ureteroscopic lithotripsy for upper ureteric stones. Materials and Methods: In a randomized controlled trial, 60 patients with an upper ureteric stone underwent URS lithotripsy either by laser or pneumatic. The inclusion criteria were age above 14 years old, of both sexes with an upper ureteric stone about 2 cm in diameter . Exclusion criteria were age below 14 years old, elevated serum creatinine level, patients with coagulopathies and pregnancy. The perioperative and postoperative outcomes were evaluated and postoperative pelvi-abdominal CT with intravenous contrast was done to detect if a subcapsular hematoma has been developed. Results: There is no significant association between the formation of subcapsular renal hematoma and degree of hydronephrosis, chronic kidney disease (CKD), body mass index (BMI), diabetes mellitus (DM), hypertension (HTN) and preoperative bacteriuria as risk factors.
Conclusions: Subcapsular hematoma post-ureteroscopic lithotripsy (URSL) for impacted upper ureteric stones is a rare but potentially serious complication. A high index of suspicion is needed when patients present with significant loin pain and fever after ureteroscopic lithotripsy for obstructing proximal ureteral stones with thin renal cortices. Stone size, degree of hydronephrosis, operation duration, and perfusion pressure of hydraulic irrigation were associated with an increased risk of SRH formation. Management of post-URSL subcapsular hematomas
needs to be customized for each patient.