Splenic hematoma: a rare complication in left percutaneous nephrostomy.

Splenic perforation is uncommon, but is nevertheless a risk during percutan eous nephrostomy. The case has been reported of complications, i.e., septic shock following a urinary infection in a patient with left hydronephrosis. The insertion via ultrasonography of a nephrostomy probe by the left subco stal route in right lateral decubitus was not easy, and collected blood but not urine. It was then correctly repositioned, thereby permitting efficien t urine drainage. The opacified appearance revealed the presence of peripye lic and perineal leakage of contrast medium, Ten days later, the patient su ffered from left hypochondrial pain and collapse. Ultrasonography revealed a large subcapsular hematoma of the spleen. Macroscopic examination showed a longitudinal wound on the posterior side of the spleen. The risks of sple nic injury during a nephrostomy increase in proportion to the difficulties encountered in carrying out the operation. (C) 2000 Editions scientifiques et medicales Elsevier SAS.