Dr. Sumit Chaudhari, a Consultant Urologist and Transplant Surgeon at Medicover Hospital in Pune, has authored a case report detailing the successful non-operative management of a massive retroperitoneal hemorrhage following a percutaneous nephrolithotomy (PCNL) attempt in a liver transplant recipient. The 53-year-old patient, who had complex medical challenges including immunosuppression and a multidrug-resistant urinary tract infection, developed two communicating hematomas totaling roughly 1.3 liters after a skin incision for a second-stage PCNL. Despite the severity of the bleeding, which required aggressive blood product transfusions, the patient remained hemodynamically stable. Serial imaging confirmed the gradual, spontaneous resolution of the hematomas without the need for angioembolization or surgery, highlighting that conservative management is a viable option for carefully selected, stable patients in complex transplant stone surgery.
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