Macro hematoma after micro percutaneous nephrolithotomy: A case report

The micropercutaneous nephrolithotomy (mPNL, microperc) method was developed in order to prevent complications. In our clinic, we performed microperc on a 39-year-old man who expelled renal stone. During the microperc procedure, lower pole calyceal access was successfully obtained to get direct access to the stone by using 4.8Fr microperc needle. The patient's hemoglobin dropped from 16.8 to 9.6 gr/dl about 6 hours after surgery. A new computerised tomography (CT) scan demonstrated a large retroperitoneal hematoma measuring 182x97x92 mm. When we performed retroperitoneal exploration, we saw a bleeding area due to the entrance of microperc needle. Then, we controlled the hemorrhage. The patient's hemodynamics remained stable and he did not need any blood transfusion after exploration. Based on this case, it appears reasonable to allow open surgery after microperc to control macro hematoma.