MASSIVE HEMORRHAGE FROM RENAL-VEIN INJURY DURING PERCUTANEOUS RENAL SURGERY - ENDOUROLOGICAL MANAGEMENT

Purpose: Although minor venous injuries respond to simple maneuvers, m ajor venous injuries pose a significant therapeutic problem and may be under diagnosed. We present our experience with major injury to the r enal vein during percutaneous renal surgery. Materials and Methods: Fo ur patients had massive hemorrhage during percutaneous renal surgery a ssociated with major injury to the renal vein, and 3 also had renal in sufficiency. All 4 patients and 1 additional patient with renal insuff iciency and massive hemorrhage from an arteriovenous fistula following percutaneous renal surgery were treated nonoperatively with a selecti vely positioned and inflated Councill balloon catheter. Results: Hemor rhage was controlled and renal function was unaffected in all 5 patien ts. Conclusions: Renal vein injuries can be associated with massive he morrhage. Patients with major vascular injuries from percutaneous rena l surgery and concomitant renal insufficiency can be treated without o pen exploration or angiographic embolization using a Councill balloon catheter.