【摘要】 经皮肾镜碎石取石术(PCNL)是一种在泌尿外科领域广泛应用的微创手术技术。该技术主要用于治疗肾结石以及输尿管上段结石，尤其是针对那些体积较大或复杂性结石病例，PCNL展现出了其独特的优势。在基层医院，B超定位下经皮肾穿刺则为首选穿刺方式，X线定位相对较少。PCNL术后并发结肠损伤是一种罕见但严重的并发症，本文报告1例患者，因左肾多发结石行PCNL,首次手术顺利，但半月后第二次手术发现原造瘘管误入结肠，经原通道镜检及影像结合考虑首次手术所致结肠损伤，但首次未及时发现，最终通过保守治疗(包括抗感染、引流)后成功治愈，避免了开放手术。结合既往文献复习，结肠损伤的诊断可综合影像学及内镜直视评估，治疗策略应根据损伤程度及患者基础状况(如免疫力、是否有合并症)个体化选择，对于局限性损伤、无腹膜炎体征者，可尝试保守治疗，但需动态监测生命体征、腹部表现及感染指标，并备选手术方案以应对病情恶化。更多还原

【Abstract】 Percutaneous Nephrolithotomy(PCNL) is a minimally invasive surgical technique widely used in the field of urology. This technology is mainly used to the treatment of kidney stones and upper ureteral stones, especially for cases involving large or complex calculi, where PCNL demonstrates unique advantages. In primary hospitals, B-ultrasound-guided percutaneous renal puncture is the preferred method, while X-ray localization is relatively less used. Colon injury is a rare but serious complication after PCNL. This article reports a case of a patient who underwent PCNL for multiple left kidney stones. The initial surgery was uneventful, but the second operation half a month later, it was discovered that the original nephrostomy tube had mistakenly entered the colon. Combined channel endoscopy and imaging suggested that the colon injury was caused by the first operation but was not detected promptly at that time. The patient was ultimately successfully treated with conservative management(including anti-infection therapy and drainage), avoiding open surgery. Based on the review of previous literature, the diagnosis of colon injury can integrate imaging and endoscopic visual assessment. The treatment strategy should be individualized according to the degree of injury and the patient’s baseline condition(such as immunity and comorbidities). For localized injuries without signs of peritonities, conservative treatment can be attempted. However, dynamic monitoring of vital signs, abdominal manifestations, and infection indicators is necessary, with a surgical options available in case of clinical deterioration.更多还原