Percutaneous Extraction of a Foreign Body in an Obstructed Transplanted Kidney

Aim: To address the possibility of an iatrogenic obstruction in a transplanted kidney and evaluate the efficacy of prompt percutaneous access in managing the condition.

Case Presentation: We present a case of a 64-year-old male, who is known case of renal transplant for nine years with hydronephrosis of the transplanted kidney, scheduled for a nephrostomy. During the procedure, the access Peel-Away sheath got displaced into the transplanted kidney and was difficult to visualize on KUB fluoroscopy due to its radiolucency. Successful intervention was carried out using percutaneous renal access with an endoscopic grasper.

Discussion: Percutaneous renal access is a minimally invasive method used in a variety of urological procedures. It is associated with several complications such as post-operative sepsis, hemorrhage and injuries to the collecting system. Prompt management of such complications is required to avoid undesired consequences. There have not been any reported incidences of nephrostomy access sheath displacement into a hydronephrotic transplanted kidney. Nevertheless, a similar incident that involved the displacement of a PCN catheter inside the abdominal cavity and within the bowel was reported.

Conclusion: Percutaneous renal access is a safe and efficient method to identify and remove foreign bodies in transplanted kidneys.