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Development of sudden refractory hypotension resulting from urosepsis in the post-anesthesia care unit after percutaneous nephrolithotomy for renal calculi: a case report
Med Biol Sci Eng 2019;2(2):55-59
Published online July 31, 2019
© 2019 Medical Biological Science and Engineering.

Gi-Ho Koh1, Doo-Hwan Kim2, Jihion Yu2, Seungsoo Ha2, Sang-A Lee2, Jai-Hyun Hwang2, Young-Kug Kim2, Jun-Young Park2

Department of Anesthesiology and Pain Medicine, 1Chosun University Hospital, Gwangju, 2Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence to: Jun-Young Park
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-1415
Fax: +82-2-3010-6790
Received March 11, 2019; Revised March 14, 2019; Accepted March 14, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Percutaneous nephrolithotomy (PNL) is a relatively safe and effective procedure for the management of nephrolithiasis but is associated with severe complications. We report the case of a 76-year-old woman who underwent PNL for renal calculi removal. Preoperative urinalysis detected a large number of white blood cells and, on culture, Escherichia coli was detected. After an uneventful recovery from general anesthesia, she developed tachycardia, high fever, severe shivering, and hypotension in the post-anesthesia care unit. She was diagnosed with urosepsis associated with PNL and was transferred to the intensive care unit. Urosepsis and refractory hypotension persisted despite meticulous fluid management and vasopressor and inotropic agent administration. On postoperative day 5, she was hemodynamically stable and was transferred to a general ward. On postoperative day 12, she was discharged without any complications. Urosepsis after PNL can be catastrophic; therefore, early detection and optimal treatment are necessary to improve the postoperative outcome.
Keywords : Kidney calculi; Nephrolithotomy, Percutaneous; Shock, Septic; Anesthesia recovery period
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