Figure 12.

A 71-year-old male with a left ureteral transection during colon resection with need for PCN. (A) CT of the abdomen demonstrated moderate left hydronephrosis (white arrow). (B) A fluoroscopic guided PCN was placed, however the initial puncture was done too centrally (black arrow). Bright red blood was noticed in the PCN bag, and the patient became hypotensive. (C) Urgent angiography was performed; however, no arterial injury was noted while the PCN drain (black arrows) was still in place. (D) The PCN was removed over a wire and repeat digital subtraction angiography was performed, revealing blood along the PCN tract (black arrows). (E) The injured artery was treated with coil embolization (white arrow), leading to resolution of contrast extravasation. PCN, percutaneous nephrostomy.