OBJECTIVE<p>This study aimed to identify the different risk factors for developing sepsis in patients undergoing percutaneous nephrolithotomyp>METHODS<p>This is a case-control study of all patients who underwent percutaneous nephrolithotomy in the National Kidney and Transplant Institute from 2017 to 2021. Demographic, stone characteristics, perioperative data and post-operative parameters were recorded. The association of clinical variables and sepsis was determined using logistic regression analysis.p>RESULTS<p>A total of 536 patients who underwent percutaneous nephrolithotomy were included in the study with 58 of them suffering from sepsis with a prevalence rate of 9.9%. The majority [392 (67.82%)] of the patients were 31-59 years old. Majority of patients suffering from sepsis also belonged to the same age group were predominantly male [33 (56.9%)], mostly diabetic [15 (26.32%)] and hypertensive [14 (24.56%)] and underwent previous PCNL [49 (8.45%)]. Imaging of patients who had sepsis showed staghorn calculi [30 (51.72%)] with mild [20 (34.48%)] and moderate [23 (39.66%)] seen on imaging. Patients who were requiring transfusion post operatively (Grade II Clavien-Dindo Classification) were seen to have sepsis.p>CONCLUSION<p>The following factors are contributory to the development of sepsis: a high Guy's stone score, high degree of obstruction or hydronephrosis, previous stone surgery and a higher volume of blood loss.p>
Human ; Nephrolithotomy, Percutaneous ; Sepsis ; Hydronephrosis

<p style="text-align: justify;">A duplicate inferior vena cava (IVC) is a rare occurrence, with a published incidence rate of 0.2 to 3 percent of the general population in the western hemisphere. Locally, based on consultations with vascular surgeons and after exhaustive search in the local literature, there is so far no reported case of this phenomenon.                                        p><p style="text-align: justify;">We present to you the first ever reported case, locally of a living related kidney donor patient with a duplicated inferior vena cava. In this case, the left IVC was taken down along with the healthy kidney through hand assisted laparoscopic donor nephrectomy with the use of an intracorporeal stapler. The vascular anomaly was identified pre- operatively hence, surgical planning was facilitated. The kidney was harvested with the most length of the ipsilateral IVC taken down with it. This was done to leave behind the shortest possible blind ending remnants of the IVC that might cause circulatory stasis and turbulence leading to the formation of venous thrombi.p><p style="text-align: justify;">This aimed to instill awareness among urologists and all surgeons in general, regarding the need to be vigilant in detecting the presence of these vascular anomalies. Failure of detection of such phenomenon might lead to a spectrum of outcome ranging from technical difficulties intra-op to the worse outcome of a disastrous postoperative complication or even worst, death of the patient. We hope that by presenting this case, we my arm our fellow surgeons with the basic knowledge of the existence of these anomalies and hence prompt them to institute preventive measures necessary for successful surgery of these patients.   p>
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