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Ureteral Penetration Caused by Drilling During Internal Pelvic Bone Fixation: Delayed Recognition

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초록

A 49-year-old man was referred to our department with profuse serous fluid discharge from a Penrose drain after undergoing internal fixation with metal screws for multiple pelvic bone fractures. A definite ureteral penetration was identified that was orientated from the lateral to the medial aspect of the right distal ureter. The patient was surgically treated with excision of the 2-cm injured ureteral segment, end-to-end ureteroureterostomy, and double J ureteral stent placement. To our knowledge, a penetrating ureteral injury caused by bone drilling has not been reported previously in the published literature. This case shows that surgeons who do pelvic surgery, including orthopedic surgeons, should be familiar with the anatomical relationship of the ureter and its potential injuries.

Abstract

A 49-year-old man was referred to our department with profuse serous fluid discharge from a Penrose drain after undergoing internal fixation with metal screws for multiple pelvic bone fractures. A definite ureteral penetration was identified that was orientated from the lateral to the medial aspect of the right distal ureter. The patient was surgically treated with excision of the 2-cm injured ureteral segment, end-to-end ureteroureterostomy, and double J ureteral stent placement. To our knowledge, a penetrating ureteral injury caused by bone drilling has not been reported previously in the published literature. This case shows that surgeons who do pelvic surgery, including orthopedic surgeons, should be familiar with the anatomical relationship of the ureter and its potential injuries.

참고문헌 (5)

  1. Preston JM, "Iatrogenic ureteric injury: common medicolegal pitfalls", BJU Int, 86, pp.313~317 (2000)
  2. Waters E, "Delayed presentation of ureteric injury after thermal insult at total hip replacement", Br J Urol, 82, pp.594~ (1998)
  3. Trinchieri A, "Renal autotransplantation for complete ureteral avulsion following lumbar disk surgery", J Urol, 165, pp.1210~1211 (2001)
  4. McAninch JW, "Renal and ureteral trauma, In Campbell-Walsh urology", pp.1282~1292 (2007), Saunders
  5. Demirkesen O, "A rare complication of lumbar disk surgery: ureteral avulsion", Int Urol Nephrol, 38, pp.459~461 (2006)

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