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Case Report

Subcapsular renal hematoma after ureteroscopy and transureteroscopic laser lithotripsy: A case report in a hospital of the western Amazon

Eliakim Massuqueto Andrade Gomes Souza, Cid Olavo Scarpa Vasconcellos, Alessandro Corrêa dos Santos Prudente, Paulo Cézar Correia Vasconcellos, Daniel Viana Carlos Cardoso, Jose Edson Puerari Benevides.

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Perirenal hematoma is a rare complication of transureteroscopic laser lithotripsy occurring in about 0.15% of cases. This rate is significantly lower than other forms of treatment, such as extracorporeal shock wave lithotripsy which presents an incidence of perirenal hematoma of up to 25%. This study reports the case of a 56-year-old woman who presented a left ureterolithiasis and a right renal cyst. She underwent a left transureteroscopic laser lithotripsy and complained of pain postoperatively although without hypotension or fever. Her abdominal CT scan showed a huge hematoma subcapsular around her left kidney without any signs of urinary leak. The patient was treated conservatively and exhibited favorable outcomes. Most renal subcapsular hematomas presents spontaneous resolution with conservative treatment, however, the puncture or surgical approach may be necessary when associated with sepsis, impaired renal function, hemodynamic instability, or urinary tract leakage evidenced on CT scans.

Key words: ureterolithiasis, ureteroscopic surgery, lithotripsy, laser therapy, Hematoma

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