Papel de la radiología intervencionista / Role of interventional radiology

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Grade 3a Clavien grade complication following percutaneous nephrolithotomy. Related factors and review of the literature.

OBJECTIVE: We review the literature about bleeding complications of percutaneous nephrolithotomy (PCNL) and the application of the modified Clavien system classification. METHODS: We present a 38 year old man who underwent left PCNL with acute severe hematuria during the immediate postoperatory time. We review the literature and analyze the usefulness of the modified Clavien system to grade perioperative complications. RESULTS: Conservative management was insufficient so we had to perform arteriography and superselective embolization to solve the acute arterial bleeding. According to Clavien's classification, our case would be included within the grade 3a group complications. CONCLUSIONS: The complications following a PCNL are not uncommon. However most of them are not severe. The modified Clavien system, used for classifying complications after performing PCNL, can be useful for reporting results in an objective and replicable way.

Factores relacionados con una complicación grado IIIa de Clavien tras una nefrolitotomía percutánea. Revisión de la literatura / Grade 3a Clavien grade complication following percutaneous nephrolithotomy. Related factors and review of the literature

OBJETIVO: Revisamos la literatura a propósito de las complicaciones hemorragicas derivadas de una Nefrolitotomia Percutánea (NLP) y la aplicación del sistema modificado de Clavien para su clasificación. MÉTODOS: Presentamos el caso de un varón sometido a una NLP izquierda que presentó de forma aguda durante el postoperatorio inmediato una hematuria severa y anemizante secundaria a un sangrado arterial. Revisamos la literatura al respecto y analizamos la utilidad del sistema de clasificación de Clavien para las complicaciones quirúrgicas. RESULTADOS: Mediante arteriografía y embolización percutánea supraselectiva del vaso sangrante se consiguió el control definitivo del sangrado arterial. Representado así una complicación grado IIIa según el sistema de Clavien. CONCLUSIONES: Las complicaciones tras una NLP, en su mayoría leves, no son infrecuentes. El sistema modificado de Clavien adaptado para clasificar las complicaciones tras una NLP puede ser de utilidad para notificar resultados de forma objetiva y reproducible

OBJECTIVE: We review the literature about bleeding complications of percutaneous nephrolithotomy (PCNL) and the application of the modified Clavien system classification. METHODS: We present a 38 year old man who underwent left PCNL with acute severe hematuria during the immediate postoperatory time. We review the literature and analyze the usefulness of the modified Clavien system to grade perioperative complications. RESULTS: Conservative management was insufficient so we had to perform arteriography and superselective embolization to solve the acute arterial bleeding. According to Clavie's classification, our case would be included within the grade 3a group complications. CONCLUSIONS: The complications following a PCNL are not uncommon. However most of them are not severe. The modified Clavien system, used for classifying complications after performing PCNL, can be useful for reporting results in an objective and replicable way