# A case report of sepsis associated coagulopathy after percutaneous nephrostomy

## TL;DR

This case report describes a rare instance of bleeding after a kidney procedure caused by sepsis-related coagulation issues, not surgery.

## Contribution

Highlights sepsis-associated coagulopathy as a rare but important cause of post-procedure bleeding in urology.

## Key findings

- A 72-year-old male developed sepsis-related coagulopathy after bilateral nephrostomy, leading to hemorrhage.
- Bleeding was resolved with symptomatic treatment after ruling out vascular injury.
- SAC/SIC should be considered in septic patients with bleeding despite minor coagulation abnormalities.

## Abstract

Hemorrhage is a common complication of nephrostomy and percutaneous nephrolithotripsy, and it is caused by surgical factors. Here we report a rare case of hemorrhage caused by sepsis-related coagulation dysfunction.

A 72-years-old male patient with bilateral ureteral calculi accompanied by hydronephrosis and renal insufficiency developed sepsis and hemorrhage on the third day after bilateral nephrostomy. After vascular injury was excluded by DSA, the hemorrhage was considered to be sepsis-associated coagulopathy(SAC/SIC), finally the patient recovered well after active symptomatic treatment.

In patients with sepsis and hemorrhage, SAC/SIC cannot be excluded even if coagulation function is slightly abnormal after surgical factors are excluded. For urologists who may encounter similar cases in their general urology practice, it is important to be aware of these unusual causes of hemorrhage.