Anesthesia & Clinical Research
Open Access

Abstract

Systemic Inflammatory Response Syndrome after Massive Extravasation into the Pleural Space of Contrast Medium during Supracostal Percutaneous Nephrolithotomy

Diogo Sobreira Fernandes, Daniel Reis, Maria Fátima Martins, Vitor Cavadas and Humberto S Machado

Percutaneous nephrolithotomy is indicated for renal stones larger than 2 cm and upper ureteral stones not amenable to retrograde management. Supracostal access may enable better access to the entire collecting system and even be preferential in some cases, although having a higher risk of pleural or lung injury, resulting in hydrothorax or pneumothorax. We report a case of a patient who developed a massive hydrothorax during surgery. In this particular case the hydrothorax was mainly composed of iodixanol (visipaque®) isosmolar nonionic contrast media. We assume that this was the reason why a subsequent systemic inflammatory response syndrome (SIRS) was observed. There is no reference in the literature to a prolonged SIRS associated to a hydrothorax mainly composed of nonionic contrast media following a supracostal percutaneous nephrolitotomy.