Complications of massive intraabdominal extravasation of fluid during percutaneous nephrolithotomy- case report

We report a case of transurethral resection of prostate (TURP) like syndrome of a 56-year-old female patient who underwent elective percutaneous nephrolithotomy (PCNL) under general anesthesia. Hypotonic sodium chloride (NaCl) solution was used in the procedure. 70 minutes intothe surgery end-tidal CO2 (EtCO2) significantly dropped and the patient was first hypertensive, then hypotensive, cyanotic, hypoxicand hyponatremic. Additionally, the patientdeveloped severe postoperative complications including acute renal insufficiency, acute pancreatitis, persistent pleural effusion. The patient alsounderwent necrosectomy procedure due to purulent and necrotic tissue in the lumbotomy incision and the removal of left perirenal abscess and hematoma. Hypotonic NaCl solution used in this PCNL procedure was inappropriate irrigation fluid.