claning
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Help! I would really love some direction on this report...37204/75894, 50690/74425, 50953, 52005 ??? am I close? sorry it's long... carol
PROCEDURE: TRANSCATHER THERAPY, EMBOLIZATION LEFT URETER
INDICATIONS: contrast study of ileal conduit. is there
extravasation of urine from left ureter to abscess cavity.
TECHNIQUE: The procedure was discussed with the patient
and informed consent obtained. The patient was prepped and
draped with usual sterile conditions.
PROCEDURE: Initially a Foley catheter was placed in the
ureterostomy in the right lower quadrant. The retrograde
ileal loop study was performed showing a patent right
ureter. Contrast did reflux into the left ureter with 2
areas of extravasation demonstrated where the ureter
crosses the left iliac stent and at the proximal ureter at
the nephrectomy site. A 7 French guide sheath and was
advanced into the ileal loop and position near the left
ureteral connection. A 5 French catheter was then coaxially
passed into the left ureter. Contrast injection
demonstrated marked extravasation from the proximal left
ureter and mild extravasation at perforation site where the
ureter crosses the left iliac stent.
The catheter was advanced over guidewire into the proximal
ureter and multiple embolization coils placed. Pledgets of
Gelfoam were then injected within the wire mesh. The
catheter was then brought down to just above the left iliac
stent and multiple coils were placed spanning the site of
extravasation. Additional pledgets of Gelfoam were injected
into the wire mesh. This resulted in complete occlusion of
the left ureter. The catheters were then removed and the
patient transferred back to the floor in stable condition.
The procedure was tolerated well. There were no
complications.
FLUOROSCOPY TIME: 48 MIN
CONCLUSION: Successful retrograde cannulation of the
isolated left ureter. 2 areas of extravasation
demonstrated. The left ureter was successfully embolized
with embolization coils and Gelfoam.
PROCEDURE: TRANSCATHER THERAPY, EMBOLIZATION LEFT URETER
INDICATIONS: contrast study of ileal conduit. is there
extravasation of urine from left ureter to abscess cavity.
TECHNIQUE: The procedure was discussed with the patient
and informed consent obtained. The patient was prepped and
draped with usual sterile conditions.
PROCEDURE: Initially a Foley catheter was placed in the
ureterostomy in the right lower quadrant. The retrograde
ileal loop study was performed showing a patent right
ureter. Contrast did reflux into the left ureter with 2
areas of extravasation demonstrated where the ureter
crosses the left iliac stent and at the proximal ureter at
the nephrectomy site. A 7 French guide sheath and was
advanced into the ileal loop and position near the left
ureteral connection. A 5 French catheter was then coaxially
passed into the left ureter. Contrast injection
demonstrated marked extravasation from the proximal left
ureter and mild extravasation at perforation site where the
ureter crosses the left iliac stent.
The catheter was advanced over guidewire into the proximal
ureter and multiple embolization coils placed. Pledgets of
Gelfoam were then injected within the wire mesh. The
catheter was then brought down to just above the left iliac
stent and multiple coils were placed spanning the site of
extravasation. Additional pledgets of Gelfoam were injected
into the wire mesh. This resulted in complete occlusion of
the left ureter. The catheters were then removed and the
patient transferred back to the floor in stable condition.
The procedure was tolerated well. There were no
complications.
FLUOROSCOPY TIME: 48 MIN
CONCLUSION: Successful retrograde cannulation of the
isolated left ureter. 2 areas of extravasation
demonstrated. The left ureter was successfully embolized
with embolization coils and Gelfoam.
