All of the following are indications of percutaneous nephrostomy, EXCEPT:
Correct Answer: Ischemic renal failure
Description: Percutaneous nephrostomy is occasionally essential, if not life saving, in the treatment of acute or chronic upper urinary tract obstruction. It is the first step in obtaining antegrade access to the kidney for various procedures. Specific indications for percutaneous nephrostomy include the following: Acute or chronic upper urinary tract obstruction in which access to the kidney is impossible from lower urinary tract because of stones, infections, tumours, or anatomic anomalies, especially when a double - j stent cannot be placed through the ureter because of above-mentioned circumstances When a patient's creatinine level is rising references range and the urine cannot be drained through the ureters. Renal pelvis disorders (eg, UPJ obstruction, horseshoe kidneys,ureter duplex, ureter fissures, double renal collecting system) Hydronephrosis in renal transplant allografts. when dilatation of the renal pelvis affects kidney function to the extent that double -j stent placement is difficult or impossible, percutaneous nephrostomy may be an easier option. Contraindication to ESWL (eg, size of patients): Most ESWL units have a weight limits of 140 kg (approximately 300 lb) Stone or tumours associated with distal obstruction or a foreign body that cannot be removed through the ureters. When rapid dilation of the nephrostomy tract is required (eg, when access is needed instantly for operative procedures within the renal collecting system (for stone removal or tumour ablation) To diagnose ureteral obstruction, filling defects, and anomalies antegrade radiography Tumours such as sarcomas, ovarian tumours,and other retroperitoneal tumors (Ormond disease, intraperitoneal tumors), can compress ureters. A nephrostomy may be required in all of these cases.
Category:
Surgery
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