Migration of clips to the colon after laparoscopic partial nephrectomy

A 78-year-old man was treated with laparoscopic partial nephrectomy for a 4 cm tumour in the lower pole of the left kidney. The patient was discharged 2 days postoperatively. Preoperatively there was no sign of metastasis; the pathology indicated complete removal of the tumour, a renal cell carcinoma. 53 days postoperatively the patient had acute onset of rectal bleeding. A colonoscopy revealed necrosis and three clips on the wall of the colon corresponding to where the descending colon passes over the left kidney. The patient was treated conservatively. Clip migration has been reported previously, but to our knowledge we present the first case of clip migration to the colon after laparoscopic partial nephrectomy. Suggestions to avoid the presented complication are made.

BMJ case reports. 2017 Apr 24*** epublish ***

Peter Fisker Vedel, Hans-Erik Wittendorf, Thomas Peter Norus

Urology Department, Sjællands Universitets Hospital, Roskilde, Denmark.