Acute Pancreatitis and Septic Shock Complicated after Ureteroscopic Stone Removal in a Patient with Ureter Stones

Korean Journal of Nephrology 2007;26(3):368-372.

Sang Mi Park, M.D.1, Chang Hee Han, M.D.2, Yoo Dong Won, M.D.3 Hee Sun Chung, M.D.1, Sang Hee Kim, M.D.1, Lee Yun Jeong, M.D.1 Young Soo Kim, M.D.1, Sun Ae Yoon, M.D.1 and Young Ok Kim, M.D.1

Department of Internal Medicine¹
Urology2 and Radiology³
College of Medicine The Catholic University of Korea, Seoul, Korea

요로결석 환자에서 요관경하 배석술 후 발생한 패혈성 쇽을 동반한 급성 췌장염

박상미1 한창희2 원유동3 정희선1 김상희1 이윤정1 김영수1 윤선애1 김영옥1

가톨릭대학교 의과대학 내과학교실1, 비뇨기과학교실2, 방사선과학교실3

Abstract

Being relatively safe, Ureteroscopy is one of the techniques most widely used for upper urinary tract diseases. Two cases of acute pancreatitis following percutaneous nephrolithotomy have been reported, but in neither case was there any complications after ureteroscopic procedure in patients with percutaneous nephrostomy. A 49-year-old male was presented with sudden onset of fever and decreased mental activity just after ureteroscopic stone removal. He had received nephrolithotomy for staghorn calculus six months before and received percutaneous nephrostomy 2 months before. Urine and blood cultures showed Citrobacter freundii and serum amylase and lipase increased to 6,067 IU/L, 1,270 IU/L, respectively. Abdominal CT scan demonstrated perinephric inflammatory fluid collection and its direct extension to the tail portion of pancreas. With medical treatment including adequate antibiotics, urosepsis and acute pancreatitis was completely cured.

Key Words: Pancreatitis, Ureteroscopy, Kidney calculi, Percutaneous nephrostomy