Top

Published in:

Open Access 01-12-2021 | Nephrectomy | Educational Review

Complications of renal interventions: a pictorial review of CT findings

Authors: Jean S. Z. Lee, Jonathan Hall, Tom Sutherland

Published in: Insights into Imaging | Issue 1/2021

Abstract

A number of potential vascular and non-vascular complications can arise from surgical, extracorporeal shock wave lithotripsy, radiotherapy and radiological renal interventions, including percutaneous image-guided biopsy and drainage. Computed tomography scan is usually one of the first and most important diagnostic imaging examinations requested when a potential complication is suspected. There are a wide range of common and uncommon potential complications from renal interventions. An understanding of underlying risk factors is important to reduce potential complications from renal intervention. Radiologists play a crucial role in recognising and diagnosing post-renal intervention complications on computed tomography scans, which could significantly improve the patient’s prognosis.

Pantuck AJ, Zisman A, Belldegrun AS (2001) The changing natural history of renal cell carcinoma. J Urol 166(5):1611–1623PubMedCrossRef

Hesse A, Brändle E, Wilbert D, Köhrmann K-U, Alken P (2003) Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000. Eur Urol 44(6):709–713PubMedCrossRef

Kittanamongkolchai W, Vaughan LE, Enders FT et al (2018) The changing incidence and presentation of urinary stones over 3 decades. Mayo Clin Proc 93(3):291–299PubMedCrossRef

Nicol D, Elstob A, Anderson C, Munneke G (2018) Subtotal nephrectomy and tumour ablation. In: Woodhouse CRJ, Kirkham A, (eds) Radiology and follow-up of urologic surgery. Wiley Blackwell, Hoboken, NJ, pp 5–21

Jayson M, Sanders H (1998) Increased incidence of serendipitously discovered renal cell carcinoma. Urology 51(2):203–205PubMedCrossRef

Kane CJ, Mallin K, Ritchey J, Cooperberg MR, Carroll PR (2008) Renal cell cancer stage migration: analysis of the National Cancer Data Base. Cancer 113(1):78–83PubMedCrossRef

Iguchi M, Umekawa T, Katoh Y, Kohri K, Kurita T (1996) Prevalence of urolithiasis in Kaizuka City, Japan–an epidemiologic study of urinary stones. Int J Urol 3(3):175–179PubMedCrossRef

Ljungberg B, Campbell SC, Choi HY et al (2011) The epidemiology of renal cell carcinoma. Eur Urol 60(4):615–621PubMedCrossRef

Wong MCS, Goggins WB, Yip BHK et al (2017) Incidence and mortality of kidney cancer: temporal patterns and global trends in 39 countries. Sci Rep 7(1):15698PubMedPubMedCentralCrossRef

10.

Geraghty RM, Jones P, Somani BK (2017) Worldwide trends of urinary stone disease treatment over the last two decades: a systematic review. J Endourol 31(6):547–556PubMedCrossRef

11.

Durner L, Bach C, El Fatih El Howairis M, Hakenberg OW, Buchholz N (2016) Current trends in urolithiasis treatment in various european health systems. Urol Int 96(2):125–131PubMedCrossRef

12.

Patel HD, Nichols PE, Su ZT et al (2020) Renal mass biopsy is associated with reduction in surgery for early-stage kidney cancer. Urology 135:76–81PubMedCrossRef

13.

Krabbe LM, Bagrodia A, Margulis V, Wood CG (2014) Surgical management of renal cell carcinoma. Semin Intervent Radiol 31(1):27–32PubMedPubMedCentralCrossRef

14.

Kim TS, Park JG, Kang H, Kang SH, Rhew HY, Kang PM (2016) Computed tomography imaging features and changes in hemostatic agents after laparoscopic partial nephrectomy. J Endourol 30(9):950–957PubMedCrossRef

15.

Kriegmair MC, Mandel P, Rathmann N, Diehl SJ, Pfalzgraf D, Ritter M (2015) Open partial nephrectomy for high-risk renal masses is associated with renal pseudoaneurysms: assessment of a severe procedure-related complication. Biomed Res Int 205:981251

16.

Harris AC, Zwirewich CV, Lyburn ID, Torreggiani WC, Marchinkow LO (2001) Ct findings in blunt renal trauma. Radiographics 21 Spec No:S201–S214PubMedCrossRef

17.

Sivit CJ, Peclet MH, Taylor GA (1989) Life-threatening intraperitoneal bleeding: demonstration with CT. Radiology 171(2):430PubMedCrossRef

18.

Lane MJ, Katz DS, Shah RA, Rubin GD, Jeffrey RB Jr (1998) Active arterial contrast extravasation on helical CT of the abdomen, pelvis, and chest. AJR Am J Roentgenol 171(3):679–685PubMedCrossRef

19.

Jeffrey RB Jr, Cardoza JD, Olcott EW (1991) Detection of active intraabdominal arterial hemorrhage: value of dynamic contrast-enhanced CT. AJR Am J Roentgenol 156(4):725–729PubMedCrossRef

20.

Gill IS, Kavoussi LR, Lane BR (2007) Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 178(1):41–46PubMedCrossRef

21.

Takagi T, Kondo T, Tajima T, Campbell SC, Tanabe K (2014) Enhanced computed tomography after partial nephrectomy in early postoperative period to detect asymptomatic renal artery pseudoaneurysm. Int J Urol 21(9):880–885PubMedCrossRef

22.

Tanagho YS, Kaouk JH, Allaf ME et al (2013) Perioperative complications of robot-assisted partial nephrectomy: analysis of 886 patients at 5 United States centers. Urology 81(3):573–579PubMedCrossRef

23.

Mehra K, Manikandan R, Dorairajan LN, Sreerag S, Jain A, Bokka SH (2019) Trifecta outcomes in open, laparoscopy or robotic partial nephrectomy: does the surgical approach matter? J Kidney Cancer VHL 6(1):8–12PubMedPubMedCentralCrossRef

24.

Cassar K, Munro A (2002) Iatrogenic splenic injury. J R Coll Surg Edinb 47(6):731–741PubMed

25.

Kaplan JR, Lee Z, Eun DD, Reese AC (2016) Complications of minimally invasive surgery and their management. Curr Urol Rep 17(6):47PubMedCrossRef

26.

Leibl BJ, Schmedt CG, Schwarz J, Kraft K, Bittner R (1999) Laparoscopic surgery complications associated with trocar tip design: review of literature and own results. J Laparoendosc Adv Surg Tech A 9(2):135–140PubMedCrossRef

27.

Smith D, Allen C (2017) Imaging after endo-urological stone treatment. In: Woodhouse CRJ, Kirkham A (eds) Radiology and follow-up of urologic surgery. Wiley, Blackwell, pp 37–56

28.

Heers H, Turney BW (2016) Trends in urological stone disease: a 5-year update of hospital episode statistics. BJU Int 118(5):785–789PubMedCrossRef

29.

Dhar NB, Thornton J, Karafa MT, Streem SB (2004) A multivariate analysis of risk factors associated with subcapsular hematoma formation following electromagnetic shock wave lithotripsy. J Urol 172(6 Pt 1):2271–2274PubMedCrossRef

30.

Schregel C, John H, Randazzo M, Keller I (2017) Influence of acetylsalicylic acid and low-molecular weight heparins on the formation of renal hematoma after shock wave lithotripsy. World J Urol 35(12):1939–1946PubMedCrossRef

31.

Naranjo Munoz J, Narváez C, Villanego F, Mazuecos MA, Ceballos M (2018) Page kidney as a complication after a shock wave lithotripsy: a case report. CEN Case Rep 7(2):330–331PubMedPubMedCentralCrossRef

32.

Simunovic D, Sudarevic B, Galic J (2010) Extracorporeal shockwave lithotripsy in elderly: impact of age and comorbidity on stone-free rate and complications. J Endourol 24(11):1831–1837PubMedCrossRef

33.

Turgut M, Can C, Yenilmez A, Akcar N (2007) Perforation of the upper ureter: a rare complication of extracorporeal shock wave lithotripsy. Urol Res 35(4):215–218PubMedCrossRef

34.

Georgescu D, Mulţescu R, Geavlete B, Geavlete P (2014) Intraoperative complications after 8150 semirigid ureteroscopies for ureteral lithiasis: risk analysis and management. Chirurgia (Bucur) 109(3):369–374

35.

Perez Castro E, Osther PJ, Jinga V et al (2014) Differences in ureteroscopic stone treatment and outcomes for distal, mid-, proximal, or multiple ureteral locations: the Clinical Research Office of the Endourological Society ureteroscopy global study. Eur Urol 66(1):102–109PubMedCrossRef

36.

Srisubat A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M (2014) Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database Syst Rev 11:Cd007044

37.

Kamphuis GM, Baard J, Westendarp M, de la Rosette JJMCH (2015) Lessons learned from the CROES percutaneous nephrolithotomy global study. World J Urol 33(2):223–233PubMedCrossRef

38.

Barba HS, Villeda-Sandoval CI, Mendez-Probst CE (2020) Frequency and risk factors for antegrade ureteral stone migration after percutaneous nephrolithotomy. Cent European J Urol 73(3):355–361PubMedPubMedCentral

39.

Michel MS, Trojan L, Rassweiler JJ (2007) Complications in percutaneous nephrolithotomy. Eur Urol 51(4):899–906PubMedCrossRef

40.

Luciani LG, Cestari R, Tallarigo C (2000) Incidental renal cell carcinoma-age and stage characterization and clinical implications: study of 1092 patients (1982–1997). Urology 56(1):58–62PubMedCrossRef

41.

Rabjerg M, Mikkelsen MN, Walter S, Marcussen N (2014) Incidental renal neoplasms: is there a need for routine screening? A Danish single-center epidemiological study. APMIS 122(8):708–714PubMedCrossRef

42.

Lim CS, Schieda N, Silverman SG (2019) Update on indications for percutaneous renal mass biopsy in the era of advanced CT and MRI. AJR Am J Roentgenol 27:1–10

43.

Finelli A, Ismaila N, Bro B et al (2017) Management of small renal masses: American Society of clinical oncology clinical practice guideline. J Clin Oncol 35(6):668–680PubMedCrossRef

44.

Campbell S, Uzzo RG, Allaf ME et al (2017) Renal mass and localized renal cancer: AUA guideline. J Urol 198(3):520–529PubMedCrossRef

45.

Korbet SM (2002) Percutaneous renal biopsy. Semin Nephrol 22(3):254–267PubMedCrossRef

46.

Pagnini F, Cervi E, Maestroni U et al (2020) Imaging guided percutaneous renal biopsy: do it or not? Acta Biomed 91(8-S):81–88PubMedPubMedCentral

47.

Bandari J, Fuller TW, TurnerIi RM, D’Agostino LA (2016) Renal biopsy for medical renal disease: indications and contraindications. Can J Urol 23(1):8121–8126PubMed

48.

Rahbar H, Bhayani S, Stifelman M et al (2014) Evaluation of renal mass biopsy risk stratification algorithm for robotic partial nephrectomy–could a biopsy have guided management? J Urol 192(5):1337–1342PubMedCrossRef

49.

Richard PO, Jewett MAS, Bhatt JR et al (2015) Renal tumor biopsy for small renal masses: a single-center 13-year experience. Eur Urol 68(6):1007–1013PubMedCrossRef

50.

Patel RM, Safiullah S, Okhunov Z et al (2018) Pretreatment diagnosis of the small renal mass: status of renal biopsy in the United States of America. J Endourol 32(9):884–890PubMedCrossRef

51.

Corcoran AT, Russo P, Lowrance WT et al (2013) A review of contemporary data on surgically resected renal masses–benign or malignant? Urology 81(4):707–713PubMedCrossRef

52.

Kümmerlin IP, Borrego J, Wink MH et al (2007) Nephron-sparing surgery and percutaneous biopsies in renal-cell carcinoma: a global impression among endourologists. J Endourol 21(7):709–713PubMedCrossRef

53.

Johnson DC, Vukina J, Smith AB et al (2015) Preoperatively misclassified, surgically removed benign renal masses: a systematic review of surgical series and United States population level burden estimate. J Urol 193(1):30–35PubMedCrossRef

54.

Welch HG, Skinner JS, Schroeck FR, Zhou W, Black WC (2018) Regional variation of computed tomographic imaging in the United States and the Risk of Nephrectomy. JAMA Intern Med 178(2):221–227PubMedCrossRef

55.

Wang R, Wolf JS Jr, Wood DP Jr, Higgins EJ, Hafez KS (2009) Accuracy of percutaneous core biopsy in management of small renal masses. Urology 73(3):586–590PubMedCrossRef

56.

Patel HD, Johnson MH, Pierorazio PM et al (2016) Diagnostic accuracy and risks of biopsy in the diagnosis of a renal mass suspicious for localized renal cell carcinoma: systematic review of the literature. J Urol 195(5):1340–1347PubMedPubMedCentralCrossRef

57.

Leveridge MJ, Finelli A, Kachura JR et al (2011) Outcomes of small renal mass needle core biopsy, nondiagnostic percutaneous biopsy, and the role of repeat biopsy. Eur Urol 60(3):578–584PubMedCrossRef

58.

Marconi L, Dabestani S, Lam TB et al (2016) Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy. Eur Urol 69(4):660–673PubMedCrossRef

59.

Herts BR, Baker ME (1995) The current role of percutaneous biopsy in the evaluation of renal masses. Semin Urol Oncol 13(4):254–261PubMed

60.

Maturen KE, Nghiem HV, Caoili EM et al (2007) Renal mass core biopsy: accuracy and impact on clinical management. AJR Am J Roentgenol 188(2):563–570PubMedCrossRef

61.

Merkus JW, Zeebregts CJ, Hoitsma AJ, van Asten WN, Koene RA, Skotnicki SH (1993) High incidence of arteriovenous fistula after biopsy of kidney allografts. Br J Surg 80(3):310–312PubMedCrossRef

62.

Sosa-Barrios RH, Burguera V, Rodriguez-Mendiola N et al (2017) Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment. BMC Nephrol 18(1):365PubMedPubMedCentralCrossRef

63.

Yuh BI, Cohan RH (1999) Different phases of renal enhancement: role in detecting and characterizing renal masses during helical CT. AJR Am J Roentgenol 173(3):747–755PubMedCrossRef

64.

Voiculescu A, Brause M, Engelbrecht V, Sandmann W, Pfeiffer T, Grabensee B (2003) Hemodynamically relevant hematuria several months after biopsy of a kidney graft: an unusual cause. Clin Nephrol 59(3):217–221PubMedCrossRef

65.

Nakatani T, Uchida J, Han YS et al (2003) Renal allograft arteriovenous fistula and large pseudoaneurysm. Clin Transplant 17(1):9–12PubMedCrossRef

66.

Corapi KM, Chen JLT, Balk EM, Gordon CE (2012) Bleeding complications of native kidney biopsy: a systematic review and meta-analysis. Am J Kidney Dis 60(1):62–73PubMedCrossRef

67.

Nicholson ML, Wheatley TJ, Doughman TM et al (2000) A prospective randomized trial of three different sizes of core-cutting needle for renal transplant biopsy. Kidney Int 58(1):390–395PubMedCrossRef

68.

Sawicka K, Hassan N, Dumaine C (2019) Direction of the biopsy needle in ultrasound-guided renal biopsy impacts specimen adequacy and risk of bleeding. Can Assoc Radiol J 70(4):361–366PubMedCrossRef

69.

Kurup AN (2014) Percutaneous ablation for small renal masses-complications. Semin Intervent Radiol 31(1):42–49PubMedPubMedCentralCrossRef

70.

Zhao LC, Chan SW, Macejko AM, Lin WW (2008) Percutaneous radiofrequency ablation-induced perinephric hematoma with acute renal failure in a solitary kidney. J Endourol 22(7):1463–1465PubMedCrossRef

71.

Uppot RN, Silverman SG, Zagoria RJ, Tuncali K, Childs DD, Gervais DA (2009) Imaging-guided percutaneous ablation of renal cell carcinoma: a primer of how we do it. AJR Am J Roentgenol 192(6):1558–1570PubMedCrossRef

72.

Pabon-Ramos WM, Dariushnia SR, Walker TG et al (2016) Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 27(3):410–414PubMedCrossRef

73.

Montvilas P, Solvig J, Johansen TE (2011) Single-centre review of radiologically guided percutaneous nephrostomy using “mixed” technique: success and complication rates. Eur J Radiol 80(2):553–558PubMedCrossRef

74.

Neustein P, Barbaric ZL, Kaufman JJ (1986) Nephrocolic fistula: a complication of percutaneous nephrostolithotomy. J Urol 135(3):571–573PubMedCrossRef

75.

Lang EK, Hanano A, Colon I (2009) Colon caliceal fistula: a complication of percutaneous nephrolithotripsy. J Urol 182(4):1580PubMedCrossRef

76.

Akbani S, Wolf JS Jr, Osterberg EC (2019) Enterorenal fistula as an unusual complication from ureteroscopic lithotripsy: a case report. J Endourol Case Rep 5(2):49–52PubMedPubMedCentralCrossRef

77.

Patel BJ, Mathur AK, Puri N, Jackson CS (2014) A rare case of nephrocolic fistula resulting from radio frequency ablation (RFA) of renal cell carcinoma. ACG Case Rep J 1(2):93–95PubMedPubMedCentralCrossRef

78.

Miyazaki M, Komatsu Y, Yoshihara T, Kimura S (2020) Bowel injury complicating percutaneous cryoablation of large renal cell carcinoma. Radiol Case Rep 15(5):580–585PubMedPubMedCentralCrossRef

79.

Mozo M, Gonzálo R, Gutiérrez JM (2018) Colorenal fistula after renal tumour cryotherapy. Int J Surg Case Rep 53:441–443PubMedPubMedCentralCrossRef

80.

Morgan AI, Doble A, Davies RJ (2012) Successful conservative management of a colorenal fistula complicating percutaneous cryoablation of renal tumors: a case report. J Med Case Rep 6:365PubMedPubMedCentralCrossRef

81.

Vanderbrink BA, Rastinehad A, Caplin D, Ost MC, Lobko I, Lee BR (2007) Successful conservative management of colorenal fistula after percutaneous cryoablation of renal-cell carcinoma. J Endourol 21(7):726–729PubMedCrossRef

82.

Wysocki JD, Joshi V, Eiser JW, Gil N (2010) Colo-renal fistula: An unusual cause of hematochezia. World J Gastrointest Pathophysiol 1(3):106–108PubMedPubMedCentralCrossRef

83.

Brinded A, Tay YK, Woods R (2020) Novel case of nephrocolic fistula secondary to stereotactic ablative body radiotherapy for clear cell renal cell carcinoma. ANZ J Surg 90(9):1800–1801PubMedCrossRef

84.

Antic T, Taxy JB (2015) Partial nephrectomy for renal tumors: lack of correlation between margin status and local recurrence. Am J Clin Pathol 143(5):645–651PubMedCrossRef

85.

Rivero JR, De La Cerda J 3rd, Wang H et al (2018) Partial nephrectomy versus thermal ablation for clinical stage T1 renal masses: systematic review and meta-analysis of more than 3,900 patients. J Vasc Interv Radiol 29(1):18–29PubMedCrossRef

86.

Renshaw AA, Powell A, Caso J, Gould EW (2019) Needle track seeding in renal mass biopsies. Cancer Cytopathol 127(6):358–361PubMedCrossRef

87.

Park SH, Oh YT, Jung DC, Cho NH, Choi YD, Park SY (2017) Abdominal seeding of renal cell carcinoma: radiologic, pathologic, and prognostic features. Abdom Radiol (NY) 42(5):1510–1516CrossRef

88.

Ploumidis A, Panoskaltsis T, Gavresea T, Yiannou P, Yiannakou N, Pavlakisc K (2013) Tumor seeding incidentally found two years after robotic-Assisted radical nephrectomy for papillary renal cell carcinoma. A case report and review of the literature. Int J Surg Case Rep 4(6):561–564PubMedPubMedCentralCrossRef

89.

Castillo OA, Vitagliano G (2008) Port site metastasis and tumor seeding in oncologic laparoscopic urology. Urology 71(3):372–378PubMedCrossRef

90.

Allen BC, Remer EM (2010) Percutaneous cryoablation of renal tumors: patient selection, technique, and postprocedural imaging. Radiographics 30(4):887–900PubMedCrossRef

91.

Akhavein A, Neuberger MM, Dahm P (2012) Tumour-seeding: a rare complication of ablative therapy for clinically localised renal cell carcinoma. BMJ Case Rep 2012:bcr2012006948CrossRef

92.

Krambeck AE, Farrell MA, Charboneau JW, Frank I, Zincke H (2005) Intraperitoneal drop metastasis after radiofrequency ablation of pararenal tumor recurrences. Urology 65(4):797PubMedCrossRef

93.

Song J, Kim E, Mobley J et al (2014) Port site metastasis after surgery for renal cell carcinoma: harbinger of future metastasis. J Urol 192(2):364–368PubMedCrossRef

Title: Complications of renal interventions: a pictorial review of CT findings
Authors: Jean S. Z. Lee
Jonathan Hall
Tom Sutherland
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keywords: Nephrectomy
Computed Tomography
Kidney Cancer
Kidney Cancer
Computed Tomography
Nephrectomy
Kidney Cancer
Nephrectomy
Published in: Insights into Imaging / Issue 1/2021
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-021-01048-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Complications of renal interventions: a pictorial review of CT findings

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2021

Imaging diagnosis of classical and new pneumoconiosis: predominant reticular HRCT pattern

Axillary lymphadenopathy at the time of COVID-19 vaccination: ten recommendations from the European Society of Breast Imaging (EUSOBI)

Deep learning-based fully automated Z-axis coverage range definition from scout scans to eliminate overscanning in chest CT imaging

Insight into gastrointestinal heterotopic pancreas: imaging evaluation and differential diagnosis

Shorter anogenital distance is observed in patients with testicular microlithiasis using magnetic resonance imaging

A team-based competition for undergraduate medical students to learn radiology within the virtual world Second Life