Presentation
The patient underwent a hysterectomy with an iatrogenic right ureteric injury and ligation. Ultrasound and CT scans showed moderate right hydronephrosis and obstructive uropathy. The patient was referred to the interventional radiology unit for urinary diversion and decompression of the renal collecting system.
Patient Data
Under local anesthesia, complete aseptic conditions, and combined ultrasound and fluoroscopy guidance, a percutaneous right nephrogram was done, followed by wire-guided PCN placement. The control nephrogram showed the nephrostomy tube to be in situ with successful urine drainage.
Case Discussion
Percutaneous nephrostomy is an interventional procedure that is used for pelvi-calyceal system decompression and urinary divergence in different clinical scenarios for example a hydronephrotic kidney with obstructive uropathy or urinary leakage. Different direct and wire-guided techniques were described in the literature under the guidance of CT, fluoroscopy, or ultrasound. In our case, we used combined ultrasound and fluoroscopy guidance with adequate post-procedural drainage and no post-procedural complications.
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