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Understanding Percutaneous Nephrostomy: Indications and Procedures Explained

Percutaneous nephrostomy is a valuable interventional radiology procedure utilized for various renal conditions. It allows for external drainage of the renal collecting duct in cases of obstruction and helps in the healing of distal structures. This technique can decompress renal and perirenal fluid collections, create tracts for inserting devices, and enable direct infusion of agents for treating conditions like nephrolithiasis. This overview will cover indications, procedural steps, and catheter types used in nephrostomy procedures.

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Understanding Percutaneous Nephrostomy: Indications and Procedures Explained

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Presentation Transcript

  1. What is wrong with this picture?

  2. Is this an ovary?

  3. What is Going on Here?

  4. Percutaneous Nephrostomy

  5. Indications • External drainage of renal collecting duct • In cases of obstruction • As a diversion to allow for healing of distal structures • Decompression of renal and perirenal fluid collections • Tract creation for inserting devices (for nephrolithotomy, biopsies, stricture dilatation, stenting) • Direct infusion of agents for dissolving stones and antibacterial, antitumor, or antifungal drugs

  6. Procedure 1) Directly approach desired calix from the posterior to opacify the collecting system. 2) Use the fluoroscopically identified collecting duct system for insertion of the catheter (this has a lot of mini steps). 3) Confirm catheter position by injecting a small amount of contrast.

  7. Tubes (2 types) Malecot Pigtail catheter

  8. What it’s supposed to look like when you’re done.

  9. Sources • Kandarpa, K. and Aruny, J.E. Handbook of Interventional Radiologic Procedures, 3rd Edition. 2002. • www.emedicine.com • http://www.e-radiography.net/ibase5/Renal/Renal_hydronephrosis_ct.jpg • http://www.e-radiography.net/ibase5/Renal/Renal_hydronephrosis_ct.jpg • http://www.learningradiology.com/caseofweek/caseoftheweekpix/cow130.jpg

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