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CASE REPORT
Delayed massive haemothorax 10 days following percutaneous nephrolithotomy
  1. Sanjay Sinha1,
  2. Ramesh G Babu2,
  3. Mallikarjun S Rao3
  1. 1Urology, Apollo Hospitals, Hyderabad, Telangana, India
  2. 2Surgery, Apollo Hospitals, Hyderabad, Telangana, India
  3. 3Pulmonology, Apollo Hospitals, Hyderabad, Telangana, India
  1. Correspondence to Dr Sanjay Sinha, drsanjaysinha{at}hotmail.com

Summary

A 56-year-old man presented with massive right haemothorax 10 days following percutaneous nephrolithotomy (PCNL) for complex, large-bulk, right renal stones. Antiplatelet medication started following coronary stenting 7 months ago was stopped 5 days prior and resumed 2 days following surgery. Stones were cleared through two tracts, one supracostal, with placement of ureteral stent but no nephrostomy. He was discharged the next day with an unremarkable chest X-ray. He developed cough and fever after 1 week. Three days later he presented with acute dyspnoea, blood pressure of 100/60 mm Hg, pulse of 120/min and haemoglobin of 9.0 g/dL. Chest X-ray and CT scan showed a large right haemothorax. Two-litre haemothorax was drained by intercostal drainage with prompt recovery. Haemothorax is a rare complication following PCNL usually after supracostal access. Most occur at or immediately following surgery. Infection and early resumption of antiplatelet medication might have contributed to his presentation with delayed secondary haemorrhage from a pleural injury.

  • urological surgery
  • respiratory system
  • respiratory medicine
  • urology
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Footnotes

  • Contributors SS (lead author), planning, concept, design, case material collection, analysis, reporting, interpretation, revision, final approval, accountable for integrity and overall responsibility. RGB (coauthor): planning, case material collection, interpretation, revision, final approval, accountable for integrity, overall responsibility. MSR (coauthor): case material collection, interpretation, revision, final approval, accountable for integrity, overall responsibility.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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