PROCEDURE: 

  1.     antegrade nephrostogram
  2.     percutaneous nephrostomy tube exchange

INDICATION:    

DATE:    

OPERATORS:

MEDICATIONS: Levaquin 500 mg IV, Versed     mg IV, fentanyl     mcg IV

FLUOROSCOPY TIME:     minutes

CONTRAST:     ml of nonionic contrast

CATHETER:     F nephrostomy tube

COMPLICATIONS: None immediate

TECHNIQUE:

The risks, benefits, and alternatives to the procedure and sedation were explained. Written informed consent was obtained.

The existing catheter and surrounding soft tissues were prepped and draped in sterile fashion. Local anesthetic was injected at the catheter entry site. A scout radiograph was obtained.

Non-ionic contrast was injected through the existing nephrostomy tube and images of the collecting system obtained.

A 0.035-inch Bentson wire was advanced through the nephrostomy tube. The tube was removed over the wire under direct fluoroscopic visualization.  A new     F nephrostomy tube was advanced over the wire and the Cope loop formed and locked in the renal pelvis. Contrast injection confirmed location. The catheter was sutured to the flank with  ___ and attached to gravity drainage. A sterile dressing was applied.

The procedure was well tolerated, and the patient was discharged from the angiography suite in satisfactory condition.

 

FINDINGS: Comparison is made to a previous exam dated ___ .

IMPRESSION:

Uneventful image-guided replacement of a ___ nephrostomy tube as described above.