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Development of sudden refractory hypotension resulting from urosepsis in the post-anesthesia care unit after percutaneous nephrolithotomy for renal calculi : a case report

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Author(s)
Gi-Ho Koh Doo-Hwan Kim Jihion Yu Seungsoo Ha Sang-A Lee Jai-Hyun Hwang Young-Kug Kim Jun-Young Park
Issued Date
2019
Keyword
Kidney calculi Nephrolithotomy Percutaneous Shock Septic Anesthesia recovery period
Abstract
Percutaneous nephrolithotomy (PNL) is a relatively safe and effective procedure for the management of nephrolithiasis but is associated with severe complications. We report the case of a 76-year-old woman who underwent PNL for renal calculi removal. Preoperative urinalysis detected a large number of white blood cells and, on culture, Escherichia coli was detected. After an uneventful recovery from general anesthesia, she developed tachycardia, high fever, severe shivering, and hypotension in the post-anesthesia care unit. She was diagnosed with urosepsis associated with PNL and was transferred to the intensive care unit. Urosepsis and refractory hypotension persisted despite meticulous fluid management and vasopressor and inotropic agent administration. On postoperative day 5, she was hemodynamically stable and was transferred to a general ward. On postoperative day 12, she was discharged without any complications. Urosepsis after PNL can be catastrophic; therefore, early detection and optimal treatment are necessary to improve the postoperative outcome.
Publisher
조선대학교 의학연구원
Citation
Gi-Ho Koh. (2019). Development of sudden refractory hypotension resulting from urosepsis in the post-anesthesia care unit after percutaneous nephrolithotomy for renal calculi : a case report, MBSE | Vol.2, No.2 p.55 ~ p.59
Type
Laboratory article
ISSN
2586-5188
URI
https://oak.chosun.ac.kr/handle/2020.oak/17111
http://www.embse.org/journal/view.html?uid=26&page=&sort=&scale=10&all_k=&s_t=&s_a=&s_k=&s_v=2&s_n=2&spage=&pn=search&year=&vmd=Full
Appears in Collections:
2019 > Vol.2, No.2
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