Migrated embolization coil: A rare cause of urinary tract obstruction
A 23-year-old male underwent left URS and PCNL for a left upper ureteric calculus and a 2.5-cm lower pole renal calculus in a community hospital in December, 2010. One week after nephrostomy tube removal, the patient experienced gross hematuria with clot retention. The patient underwent endoscopic bladder clot evacuation and DJ stent removal in the same hospital. Two weeks later, again he developed gross hematuria with fever and a significant decrease in hematocrit. After resuscitation the patient was referred to our centre. On angiography, there was a pseudoaneurysm in the lower segmental renal artery. Three 6-mm coils were positioned proximal and distal to the neck of the pseudoaneurysm. A check angiogram demonstrated no leak of contrast. Postembolization recovery was uneventful.\nAfter 3 months of embolization, the patient presented with high-grade fever, left flank pain and burning micturiton. On X-ray KUB 2 coils were seen in left renal area, whereas 1 coil was seen in L3 transverse process area. Ultrasonography revealed left moderate hydroureteronephrosis till upper 1/3 of ureter. Axial noncontrast and contrast-enhanced CT images showed left hydronephrosis with dilated upper ureter and an embolization coil in the upper ureter []. Urosepsis was controlled with antibiotics. Subsequently the patient underwent left ureteroscopic removal of the embolization coil. He was discharged on postoperative day 1.