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ECR 2019 / C-3601
Imaging and interventional management of post-operative urological complications - Radiologist to the rescue!
Congress: ECR 2019
Poster No.: C-3601
Type: Educational Exhibit
Keywords: Trauma, Acute, Abscess, Drainage, Diagnostic procedure, Abscess delineation, Percutaneous, Fluoroscopy, CT, Urinary Tract / Bladder, Interventional non-vascular, Abdomen
Authors: R. Vaja, M. Akobeng, D. Akhtar, A. Patel; Stevenage/UK
DOI:10.26044/ecr2019/C-3601

Background

Complications in the early post-operative period following urological surgery are common, particularly with high risk procedures such as robotic assisted cystectomy.

 

Clinical symptoms and signs to suggest complications include:

 

  • Abdominal pain and signs of peritonism
  • Tachycardia and increased respiratory rate
  • Pyrexia and raised inflammatory markers (white cell count and CRP)
  • Excessive output from surgical drains (particularly with high creatinine content)
  • Prolonged paralytic ileus
  • Unusually slow post-operative recovery 

 

Early diagnosis is key to management and largely relies on contrast enhanced CT with excretory phase imaging. This enables accurate detection of infected abdomino-pelvic fluid collections which may require percutaneous image guided drainage and the identification of contrast extravasation suggestive of urine leak. Interventional radiology techniques to allow urinary diversion include retrograde placement of ureteric stents and percutaneous nephrostomy.  

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