Abstract

Objectives: We investigated the value of computed tomography guided nephrostomies in patients with absent or minimal pelvicaliceal dilatation and with different kidney anatomy and localization without using ultrasound and fluoroscopy.

Material and Methods: We attempted 48 computed tomography guided nephrostomy placements in 40 patients. Both puncture of collecting system and placement of the catheters were made under computed tomography guidance. The Seldinger method was used in all procedures.

Results: Percutaneous nephrostomies were successfully achieved in all patients without major complications. There were minimal dilatation of the pelvicaliceal systems in 28 (58.3%) of 48 nephrostomies. Four patients had obesity, and another 4 had rotation anomaly. One patient had both ectopic located and malrotated kidney. One patient had subcapsular haematoma and another one had retrorenal colon variation. Eighteen of the percutaneous nephrostomies were made intercostally. Single puncture was used in 35 (73%) and twice puncture were used in 13 (27%) procedures. The time necessary for the procedure ranged from 17-36 min (mean 28 min).

Conclusion: Computed tomography guided percutaneous nephrostomy is a safe method with low rate of complications especially in patients with obesity, without pelvicaliceal dilatation or with minimal dilatation and patients with ectopic, malrotated kidneys and retrorenal colon variations.