Table 1.
Summary of case reports of bowel injury from PCNL
| Case | Location of injury | Timing of diagnosis | Risk factors | Symptoms/signs | Management |
|---|---|---|---|---|---|
| Goger E, et al. (2012)7 | Ascending colon | Intraoperative | None | None (attempted pyelogram showed contrast in bowel) | Non-operative (PCN tube withdrawn into bowel) |
| Descending colon | POD 3 | Left PCNL, lower pole access | Feculent nephrostomy drainage, fever | Non-operative** | |
| Kachrilas S, et al. (2012)16 | Ascending colon | Intraoperative | None | None | Non-operative** |
| Descending colon | POD 2 | Left PCNL, lower pole access | Fever, abdominal pain | Non-operative** | |
| Descending colon | POD 3 | Left PCNL, lower pole access | Fever, abdominal pain, nausea/vomiting | Non-operative** | |
| Juan YS, et al. (2006)9 | Descending colon | POD 4 | Left PCNL, lower pole access | Flank pain, purulent discharge around PCN, poor urine output from PCN | Non-operative** |
| Al-Assiri M, et al. (2005)6 | Jejunum | Intraoperative | Left PCNL, lower pole access, posterior axillary access | None (attempted pyelogram showed contrast in bowel) | Non-operative (catheter drainage of bowel, ureteral stent) |
| Noor Buchholz NP (2004)8 | Ascending colon | POD 2 | Female, lower pole access | Flank pain, feculent nephrostomy drainage, leukocytosis | Operative (bowel resection, ureteral stent) |
| Begliomini H, Mattos Jr. D. (2002)17 | Descending colon, Jejunum | POD 1 | Left PCNL, posterior axillary access | Abdominal pain | Operative (primary repair of bowel perforation) |
| Goswami AK, et al. (2001)5 | Descending colon | POD 1 | Left PCNL, horseshoe kidney | None (incidental finding on imaging to assess residual stone burden) | Non-operative** |
| Descending colon | POD 3 | Female, left PCNL, lower pole access | Fever, feculent nephrostomy drainage, abdominal pain | Non-operative (PCN removed, pericolonic drain, ureteral stent) | |
| Descending colon | “Early postoperative” | Left PCNL | Fever | Non-operative (PCN removed, pericolonic drain, nasogastric drain) | |
| Gerspach JM, et al. (1997)18 | Ascending colon | POD 0 | Lower pole access | Fever | Non-operative (PCN removed, ureteral stent) |
| Descending colon | POD 2 | Left PCNL, lower pole access | Feculent nephrostomy drainage | Non-operative (PCN removed) | |
| Ascending colon | Intraoperative | None | None (attempted nephroscopy visualized colon lumen) | Non-operative (catheter drainage of bowel, pericolonic drain, ureteral stent) | |
| Appel R, et al. (1988)19 | Descending colon | POD 5 | Female, left PCNL | None (incidental finding on imaging) | Non-operative (ureteral stent, bowel rest) |
| Neustein P, et al. (1986)20 | Descending colon | POD 4 | Left PCNL | Abdominal pain | Non-operative** |
| Culkin DJ, et al. (1985)21 | Duodenum | POD 3 | Female, lower pole access | Lack of nephrostomy drainage | Non-operative (PCN drainage, nasogastric drainage) |
| Descending colon | POD 0 | Left PCNL, lower pole access | Shock, rectal hemorrhage | Operative (bowel resection w/transverse colostomy and heminephrectomy) | |
| Vallancien G, et al. (1985)3 | Descending colon | POD 1 | Left PCNL, lower pole access | Abdominal pain, fever, gas from nephrostomy tract | Operative (primary repair of bowel perforation) |
PCNL: percutaneous nephrolithotomy; POD: postoperative day; PCN: percutaneous nephrostomy.
**
PCN tube withdrawn into bowel to establish colocutaneous fistula; ureteral stent inserted.