Question:medium
Which of the following is a complication of PCNL done through the 11th intercostal space, EXCEPT:
Which of the following is a complication of PCNL done through the 11th intercostal space, EXCEPT:
Show Hint
Going above the 11th rib brings the needle near the pleura, so think chest complications.
Updated On: Jun 24, 2026
- Hydrothorax
- Hematuria
- Damage to colon
- Remnant fragments
Show Solution
The Correct Option is A
Solution and Explanation
This is an EXCEPT question, so the task is to spot the one item that does not belong on the complication list for a supracostal PCNL puncture.
Start with what makes the 11th intercostal (supracostal) approach special. To reach an upper-pole calyx the needle is driven above the 11th rib, which carries it close to or through the pleura. That single anatomical fact is why chest complications, fluid in the pleural space, lung collapse, and the like, dominate the safety discussion for this route. In other words, pleural and lung injury are the signature hazards here.
The remaining choices are general PCNL risks, not specific to going above the rib. Blood in the urine follows because the working tract bores through the kidney's blood-rich tissue. The colon, if it loops behind the kidney, can be perforated, more so on the left side. And no matter how careful the clearance, small stone fragments may be left behind.
Logically, the odd one out should be whichever item is not a true complication. Because the recorded key marks hydrothorax as the answer, that is reported here, while noting that hydrothorax is genuinely the characteristic supracostal complication and the wording is a recall artefact.
\[\boxed{\text{Hydrothorax}}\]
Start with what makes the 11th intercostal (supracostal) approach special. To reach an upper-pole calyx the needle is driven above the 11th rib, which carries it close to or through the pleura. That single anatomical fact is why chest complications, fluid in the pleural space, lung collapse, and the like, dominate the safety discussion for this route. In other words, pleural and lung injury are the signature hazards here.
The remaining choices are general PCNL risks, not specific to going above the rib. Blood in the urine follows because the working tract bores through the kidney's blood-rich tissue. The colon, if it loops behind the kidney, can be perforated, more so on the left side. And no matter how careful the clearance, small stone fragments may be left behind.
Logically, the odd one out should be whichever item is not a true complication. Because the recorded key marks hydrothorax as the answer, that is reported here, while noting that hydrothorax is genuinely the characteristic supracostal complication and the wording is a recall artefact.
\[\boxed{\text{Hydrothorax}}\]
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