PMC6362790_01
Peroperative kidneys, ureters, and bladder X-ray after the placement of double J stents bilaterally in a man with bilateral renal colic pain due to ureterolithiasis. The left stent was positioned correctly. The right stent projected cranially at T12 and showed a somewhat medial position, but a nice proximal curl was noted. Because of the suspicion of an aberrant position, a computed tomography scan was planned
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F1
Perioperative kidneys, ureters, and bladder radioscopy showed a somewhat medial position of the right stent, but a nice proximal curl was noted [Figure 1].
During hospitalization, right renal colic pain and high fever persisted after the placement of double J stents bilaterally. A follow-up multislice noncontrast computed tomography scan of the abdomen was performed which showed a perforated right distal ureter with intravascular migration of the double J stents in the internal iliac vein all the way up to the inferior vena cava. The proximal curl is noted at the level of the left renal vein. No free fluid or air intra-abdominally could be detected. The distal tip is still seen in the bladder
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F2
IVC - at the level of the left renal vein - was seen in combination with right-sided hydronephrosis [Figure 2]. Inferior venocavagraphy was performed which confirmed the intravascular position of the stent and excluded the formation of significant thrombus at its tip [Figure 3a].
(a) Inferior venocavagraphy confirmed the intravascular position of the stent and excluded the formation of thrombus at the tip of the stent. (b) Ten minutes after stent removal only limited contrast extravasation was seen at the perforation site
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F3
IVC - at the level of the left renal vein - was seen in combination with right-sided hydronephrosis [Figure 2]. Inferior venocavagraphy was performed which confirmed the intravascular position of the stent and excluded the formation of significant thrombus at its tip [Figure 3a]. Immediate inferior venocavagraphy after DJS removal showed limited contrast leakage at the perforation site, and a fully clear image was noted after 10 min [Figure 3b].