Incidental misplacement of a percutaneous nephrostomy tube in the inferior vena cava

Introduction. An isolated renal pelvis rupture is a rare type of blunt trauma that can occur mostly in patients with pre-existing hydronephrosis due to different causes. We presented patient the misplacement percutaneous nephrostomy tube during treatment caused by post-irradiation ureteral stricture. Case report. A 36-year-old woman was referred our institution her gynaecologist for retroperitoneal urinoma. She had completed irradiation concurrent cisplatin chemotherapy uterine malignancy one year ago. computed tomography scan showed an left hydronephrosis. catheter misplaced inferior vena cava urinary drainage attempt. The underwent laparotomy, suture and ureteroneocystostomy indwelling double pigtail stent. removed same surgical procedure. Conclusion. Inadvertent injury vascular structures possible complication under ultrasound guidance. It may have been avoid reported if dilation tract over guidewire performed contrast-enhanced X-ray fluoroscopy.