We aim to report a rare case of colonic perforation post percutaneous nephrolithotomy (PCNL) and its conservative management.We report a 63-year-old Malay, thalassemia carrier male who underwent an uncomplicated left PCNL fora left renal stone. On second postoperative day, clinically evidence of subcutaneous emphysema. Serial CXR imaging confirmed presence of air under diaphragm. Small colonic perforation was diagnosed which subsequently developed localized collection retroperitoenally. He was successfully treated with non-operative management including intravenous antibiotic, surgical drainage and good nutrional has successfully support healed the collection. Serial CT renal protocol showed a healed retroperitoneal collection and patient made a good clinical recovery.PCNL has promising stone clearance rate. However, it carries complications. A rare yet important complication; colonic perforation is a serious complication that if detected earlier, good clinical recovery can be achieved conservatively.
Priapism is caused by an imbalance between penile blood inflow and outflow. There are two types of priapism: low-flow priapism due to venous occlusion and high-flow priapism due to uncontrolled arterial flow to the veins. High-flow priapism most frequently occurs as a result of penile trauma in which the intercavernosal artery disruption causes an arteriocavernosal fistula. It is rarely encountered in the pediatric and prepubertal population. Clinically, it manifests as a painless, prolonged erection after perineal trauma. Treatment ranges from expectant management to open surgical exploration with vessel ligation. We report the successful treatment of high-flow priapism in a 12-year-old prepubertal boy with superselective embolization.