A rare case of persistent nephropleural fistula following percutaneous nephrolithotomy

Abstract

Nephropleural fistula following percutaneous nephrolithotomy (PCNL) is a very rare complication and there are only a few case reports available in the literature. We present a case of a 65-year-old male patient with a right staghorn renal calculus and a left upper ureteric calculus who developed a right nephropleural fistula following right-sided PCNL. The patient required intercostal tube drainage. The cause of the fistula was identified to be a superior calyceal infundibular obstruction due to tiny residual stone fragments and oedema, which was endoscopically dilated, and the fistula subsequently healed. Urinary diversion using chest drainage and percutaneous nephrostomy followed by infundibular dilation and removal of secondary stones allowed the successful closure of the nephropleural fistula in our case.