One case of massive bleeding due to injury to inferior vena cava during percutaneous nephrolithotomy
Percutaneous nephrolithotomy(PCNL)is a common method used for treating kidney stones,and intraoperative bleeding is one of the most common complications.This article reports a case who experienced sig-nificant intraoperative bleeding due to inferior vena cava injury during PCNL.The patient exhibited hemodynamic instability,so an immediate exploratory laparotomy was necessary.During the exploration,damage to the inferior vena cava and renal vessels were discovered.Repairing the inferior vena cava was attempted,but substantial bleeding remained.Considering the irreparable damage to the renal vessels,a decision was made to proceed with nephrectomy.Relevant literature revealed that inadvertent entry into the inferior vena cava is a rare complication of PCNL.Factors such as the selection of puncture sites,wire manipulation,and depth of dilation may increase the risk of inferior vena cava injury.By summarizing this case and the related literature,awareness and vigilance among physicians regarding this complication can be heightened,thereby reducing the occurrence of similar complications.
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