A ureteral single-J stent in the right atrium: a case report
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(2020) 14:159
CASE REPORT
Open Access
A ureteral single-J stent in the right atrium: a case report Laure Arts1* , Sofie Willems2 and Dirk Michielsen2
Abstract Background: J stents are commonly used to support the continuity of the urinary tract. Although intravascular, and more specific intracardiac, migrations have been described, they remain infrequent and unrecognized. Case report: We report the case of a 57-year-old Caucasian woman with an intracardial migration of a single-J stent after pelvic exenteration. The intracardiac presence of single-J stent was probably due to a perioperative misplacement of the stent in the left ovarian vein. Retrieval was done under fluoroscopic control without any adverse events. Conclusions: Intravascular migration of urological stents is uncommon but can cause serious morbidities and even mortality. Perioperative precautions must be taken to avoid this problem. In case of migration, early diagnosis and management are primordial and involve a multidisciplinary approach. Keywords: J stent, intravascular migration, surgical complication, case report
Background Single- and double-J stents are commonly used to maintain urinary flow from kidney to bladder, even after restoring the continuity of the urinary tract in multiple conditions. Several complications such as discomfort, urinary tract infection (UTIs), stent fracture, encrustation, and migration are well known [1]. Although intravascular [2, 3], and more specific intracardiac [2, 4], migrations of J stents have been described, these complications remain infrequent and unrecognized. We report the case of an intracardiac migrated single-J stent (SJS) in a patient with an ureterocutaneostomy that was retrieved under fluoroscopic control. Case presentation We present the case of a 57-year-old Caucasian woman with a complex history of multiple abdominal surgeries involving gastric bypass, right hemicolectomy, sigmoidal * Correspondence: [email protected] 1 Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium Full list of author information is available at the end of the article
perforation, and cholecystectomy. Retroperitoneal fibrosis was suspected due to previous radiotherapy for cervical carcinoma, and her abdomen was considered as hostile. Our patient was on home parenteral nutrition because of a chronic intestinal obstruction due to internal herniation. Our patient was initially admitted because of purulent and fetid discharge from her abdominal wound. She was hemodynamically stable without fever and only a limited elevated C-reactive protein (CRP,18 mg/l) without an elevated white blood cell count (WBC, 8000/mm3). Several enterovesical − cutaneous and vaginal − fistulae were discovered. Because of pneumaturia, vaginal losses, sepsis with acute renal failure (hemodynamically stable with CRP level of 270 mg/l, WBC of 18,000/mm3, creatinine level of 5.5 mg/dl, and a SOFA [Sequential (Sepsis-related) Organ Failure Assessment] score of 4) [5] secondary to UTI and pyeloneph
