Splenic Trauma During a Percutaneous Nephrolithotomy

 

Splenic injury typically occurs when trying to access the upper pole of the left kidney using a supracostal approach.

 

If the diagnosis is suspected during the procedure then an imaging study can quickly confirm the diagnosis.

 

Some patients are not recognized until after the procedure. The patient may show significant bleeding when removing the nephrostomy tube.

 

In most cases the patient can be treated conservatively.

(1) Carey et al left the nephrostomy tube in place for 2 weeks before removing it, with the patient on strict bedrest.

(2) Desai et al inserted Gelfoam pledgets while withdrawing the tube.