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Migration of a Hem-o-Lok Clip to the Ureter Following Laparoscopic Partial Nephrectomy Presenting With Lower Urinary Tract Symptoms

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초록

We report a case of ureteral migration of a surgical clip after partial nephrectomy in which the clip was misdiagnosed as a ureteral stone. A 37-year-old woman had undergone laparoscopic partial nephrectomy of right renal cell carcinoma at another hospital 2 years previously. Postoperatively, she had gradually acquired lower urinary tract symptoms. Then, she complained of sudden right flank pain for a week. A plain X-ray and enhanced abdominopelvic computed tomography scan were performed. A 0.5 cm×1.0 cm right upper ureteral opacity with borderline hydronephrosis was seen but could not be found on the X-ray. Ureteroscopy revealed a medium-sized Hem-o-Lok clip on the right upper ureter that was removed with a stone basket. We concluded that a Hem-o-Lok clip used for collecting system sealing had migrated to the ureter and had been misdiagnosed as a ureteral stone on a computed tomography scan.

Abstract

We report a case of ureteral migration of a surgical clip after partial nephrectomy in which the clip was misdiagnosed as a ureteral stone. A 37-year-old woman had undergone laparoscopic partial nephrectomy of right renal cell carcinoma at another hospital 2 years previously. Postoperatively, she had gradually acquired lower urinary tract symptoms. Then, she complained of sudden right flank pain for a week. A plain X-ray and enhanced abdominopelvic computed tomography scan were performed. A 0.5 cm×1.0 cm right upper ureteral opacity with borderline hydronephrosis was seen but could not be found on the X-ray. Ureteroscopy revealed a medium-sized Hem-o-Lok clip on the right upper ureter that was removed with a stone basket. We concluded that a Hem-o-Lok clip used for collecting system sealing had migrated to the ureter and had been misdiagnosed as a ureteral stone on a computed tomography scan.

참고문헌 (7)

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  4. 이소연, "Current Status of Partial Nephrectomy for Renal Mass", Korean Journal of Urology, 52(5), pp.301~309 (2011), 대한비뇨기과학회
  5. Miller M, "Resorbable clip migration in the collecting system after laparoscopic partial nephrectomy", Urology, 67, pp.845~ (2006)
  6. Massoud W, "Spontaneous migration of a surgical clip following partial nephrectomy", Urol J, 8, pp.153~154 (2011)
  7. Tugcu V, "Stone formation from intravesical Hem-o-lok clip migration after laparoscopic radical prostatectomy", J Endourol, 23, pp.1111~1113 (2009)

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