Intracaval Migration of Ureteral Stent

[Intracardiac migration of the ureteral single-J : A case report and removal techniques]

The techniques of derivation of the high urinary tract are indispensable in common practice for the management of ureteral obstructions. Like any surgical gesture, its techniques are not without complications; Among those common are hematuria, urinary incontinence, migration in the bladder and rupture of the probe. However, intracardiac probe migration has rarely been described. We report the case of a 68-year-old patient treated for cervical cancer who benefited from the rise of a bilateral single-J probe, admitted for accidental migration of the left probe into the heart. The diagnosis was made by plain abdominal X-ray and confirmed by thoraco-abdominal CT angiography. The patient benefited, in the catheterization room, from a withdrawal of the probe by endoscopic way and under radioscopic control successfully and without any incident.

Double-J Stent Misplacement in the Inferior Vena Cava and Right Atrium: A Urovascular Nightmare

Ureteral injury may occur during abdominopelvic surgery given its anatomic path and proximity to surrounding organs. We present a case in which a patient required ureteral reimplantation following injury during a hysterectomy. The patient underwent a seemingly uncomplicated robotic ureteral reimplantation with ureteral stent placement. However, postoperative imaging demonstrated extension of the stent from the bladder to the right atrium. It appeared that the gonadal vein was reimplanted rather than the ureter. In a combined urology-vascular surgery case, gonadal vein implantation into the bladder was confirmed. Through-and-through access from the right internal jugular vein to the urethra was established. The ureteral stent was removed and the gonadal vein was embolized, with urology follow-up for planning and scheduling of ureteral reimplantation. Vascular involvement by ureteral stents has considerable risks and often requires further surgery. Ureteral injury can occur even in the hands of experienced surgeons and has a considerable impact on patients. Recognizing important anatomy and using operative techniques to differentiate from nearby structures, such as the gonadal vein, may help in preventing ureteral injury and assisting with repair of ureteral injury.

Patient summary

We describe a case in which a patient had an injury to her ureter, the tube that transports urine from the kidney to the bladder. When trying to repair this, a blood vessel (the gonadal vein) instead of the ureter was accidentally connected to the bladder. We discuss the resulting complications and management, similar cases, and important anatomy concepts and surgical techniques to prevent this type of injury.

Double J stent malposition in the inferior vena cava: Two case reports and a literature review

Double J stent (DJS) malposition in the vascular system is a rare and severe complication. We present two cases in our department who went through DJS malposition in the inferior vena cava and our experience in treatment, and we reviewed the previous case reports to further summarize its underlying reasons and prevention and treatment methods.

Intracardiac Migration of the Ureteral Double-J Stent during Percutaneous Nephrolithotomy

The complications of percutaneous nephrolithotomy (PNL) include hemorrhage, damage to adjuvant organs, and other medical issues, although intracardiac migration of ureteral double-J stent has never been found during PNL and delaying the diagnosis might cause mortality. We report the case of a 60-year-old male who was admitted to receive one-stage PNL for right renal stones. During operation, an unexpected atrial fibrillation with a drop in blood pressure was suddenly encountered and the chest X-ray subsequently showed that the ureteral double-J had penetrated deep into the heart. Emergent endovascular intervention was performed to remove the stent and the patient was uneventfully discharged 2 days later.

Management of inadvertent intracaval placement of JJ stents and intracardiac migration during PCNL: Report of 1 extremely rare case

Among the various rare complications that occur in the treatment of urolithiasis procedures, stent migration is rare, and most of them are into the renal veins or inferior vena cava (IVC). In this report, we describe one case of PCNL stent misplacement into the heart, causing arrhythmia. After identifying the stent migration, based on the location, the DJS was taken out through supraclavicular vein.

Intravascular double J stent migration: A case report, review, and management algorithm

A double J stent (DJS) is the main therapy for ureteral obstruction when conservative treatment fails. Antegrade migration in the bladder - or retrograde migration in the ureter - are well-known complications. We present a case with intravascular migration of a DJS into the inferior vena cava. Inferior venocavagraphy confirmed the position of the stent, and thrombus formation was excluded at its tip. The stent was retracted endoscopically. After the procedure, limited contrast leakage was seen at the perforation site on venography. The current available literature is reviewed. Based on this, a management algorithm is drawn up.