Not following doctor's appointment schedule, man suffers dangerous complications

On the afternoon of August 26, the Central Hospital for Tropical Diseases announced that it had just received and successfully treated the case of patient LKT (64 years old, in Hanoi ) who had suffered serious complications due to subjectively not following the doctor's appointment schedule, allowing the JJ catheter (also known as JJ catheter, double J-shaped ureteral catheter - a type of soft catheter, curved at both ends like the letter J) to be left in the body for 2 years.

Two years earlier, Mr. T. was diagnosed with bladder cancer, had a total cystectomy, and had two percutaneous ureteral stents inserted.

After surgery, Mr. T had a JJ catheter placed (from the renal pelvis to the ureter to drain urine out, while waiting for the ureter to recover from damage.

According to the instructions, the JJ catheter should be removed within 3 months. However, Mr. T. did not go for a follow-up examination to remove the catheter because he thought his health was normal, despite being reminded many times by the doctor and his family.

About 2 weeks ago, Mr. T felt tired, had a slight fever and discovered a piece of the JJ catheter had broken and was leaking out of the colostomy bag. Panicked, he went to the hospital for a check-up.

“After examination, we could not remove the JJ catheter by conventional methods. Due to the long time the catheter was in place, the patient was ordered to have a CT scan.

The results showed that the stones were attached around the JJ catheter, occupying almost the entire area of the renal pelvis on both sides. The right kidney had a large stone measuring 34x29mm, the left kidney 20x13mm with many small scattered stones. The stones on the kidney caused grade 3 hydronephrosis.

In particular, the patient's blood potassium index was up to 6.9 mmol/L (normal blood potassium is from 3.5 mmol/L to 5.0 mmol/L), with the risk of cardiac arrest at any time. Therefore, the patient was taken for emergency dialysis immediately," said Dr. Tran Duy Hien, Department of General Surgery, Urology and Andrology.

After the dialysis process returns the potassium level to normal, the patient is given antibiotics to control the infection.

Immediately afterwards, the patient underwent percutaneous nephrolithotomy on both kidneys. After lithotripsy, re-examination showed that the kidneys were still inflamed and severely swollen.

"Previously, in cases like this, the patient would have to undergo open surgery on both kidneys to remove the JJ catheter - a method that causes great damage to kidney function and affects the patient's health. Today, thanks to modern technology, the patient can undergo percutaneous nephrolithotomy, which helps remove stones effectively and minimally invasively. Thanks to that, the patient recovers very well, does not need to undergo dialysis again, and kidney function has improved significantly. After only 5 days, the patient's health was stable and he was ready to be discharged from the hospital," Dr. Hien shared.

Doctor Hien recommends: “Patients after intervention to break up urinary, ureteral, and kidney stones often have a temporary JJ catheter placed. It is very important to remove the JJ catheter on time. Patients must follow the doctor's appointment to remove the catheter. In case of abnormalities after catheter placement or if the patient has not removed the catheter on time, they should contact the medical facility immediately to avoid leaving the catheter in for too long”./.

(Vietnam+)

Source: https://www.vietnamplus.vn/khong-tuan-thu-lich-hen-cua-bac-sy-nguoi-dan-ong-gap-bien-chung-nguy-hiem-post1058057.vnp