Obstruction of the renal pelvis due to an insoluble blood clot after epsilon-aminocaproic acid therapy: resolution with intraureteral streptokinase instillations.

Abstract

We demonstrate the effectiveness of intraureteral streptokinase instillations for the resolution of an insoluble blood clot in the renal pelvis. A patient with renal adenocarcinoma had prolonged hematuria related to involvement of the "pyelum" by the tumor. An insoluble blood clot obstruction of the left renal collecting system developed as a consequence of epsilon aminocaproic acid therapy, which was treated with low dose streptokinase through a ureteral catheter. Complete resolution of the clot and obstruction occurred within 3 days of therapy. This relatively simple approach should be used for the treatment of obstruction before radical surgery is performed.