Skip to main content

Advertisement

Log in

Neurologic Injury Resulting in Flank Bulge After Percutaneous Nephrolithotomy: a Case Series

  • Case Report
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Abdominal flank bulging is a known sequela after flank incision performed for a variety of renal, vascular, and neurosurgical procedures. The incidence of incisional flank bulge in renal surgery ranges from 3 to 49%, and although it is not considered a major complication, it has a negative effect on the quality of life of the patients. Damage to the intercostal nerves during surgery via a flank incision can be caused by division, retractor pressure, a suture, or compression by fibrous tissue during the wound healing process. However, with the advent of percutaneous minimally invasive techniques in renal surgery, this denervation injury has been scarcely described in the literature. We report a rare complication of flank bulge after supracostal percutaneous nephrolithotomy in three patients. We highlight the potential importance of intercostal nerve anatomy in preventing neurologic injury as a key pathogenetic cause of the bulging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Turk C, Petrik A, Sarica K et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69(3):475–482

    Article  Google Scholar 

  2. Fahim DK, Kim SD, Cho D, Lee S, Kim DH (2011) Avoiding abdominal flank bulge after anterolateral approaches to the thoracolumbar spine: cadaveric study and electrophysiological investigation. J Neurosurg Spine 15(5):532–540

    Article  Google Scholar 

  3. Chatterjee S, Nam R, Fleshner N, Klotz L (2004) Permanent flank bulge is a consequence of flank incision for radical nephrectomy in one half of patients. Urol Oncol 22(1):36–39

    Article  CAS  Google Scholar 

  4. Gardner GP, Josephs LG, Rosca M, Rich J, Woodson J, Menzoian JO (1994) The retroperitoneal incision. An evaluation of postoperative flank 'bulge'. Arch Surg 129(7):753–756

    Article  CAS  Google Scholar 

  5. Lantz AG, Pace KT, Honey RJ (2013) Flank bulge following supracostal percutaneous nephrolithotomy: a report of 2 cases. Can Urol Assoc J 7(7–8):E547–E549

    Article  Google Scholar 

  6. Bhayani SB, Allaf ME, Su LM, Solomon SB (2005) Neuromuscular complications after percutaneous radiofrequency ablation of renal tumors. Urology. 65(3):592

    Article  Google Scholar 

  7. McAllister M, Lim K, Torrey R, Chenoweth J, Barker B, Baldwin DD (2011) Intercostal vessels and nerves are at risk for injury during supracostal percutaneous nephrostolithotomy. J Urol 185:329–334

    Article  Google Scholar 

  8. Chakraborty JN, Deb A (2018) Flank bulge following subcostal percutaneous nephrolithotomy. Res Rep Urol 10:195–197

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stilianos Giannakopoulos.

Ethics declarations

Statement of Informed Consent

The subjects have given their written informed consent for publication of their images.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Argyriou, C., Giannakopoulos, S., Tasopoulou, KM. et al. Neurologic Injury Resulting in Flank Bulge After Percutaneous Nephrolithotomy: a Case Series. Indian J Surg 82, 96–99 (2020). https://doi.org/10.1007/s12262-019-01918-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-019-01918-z

Keywords

Navigation