Sekiguchi Y, Miyai K, Noguchi K, Hosaka M, Takebayashi S, Ishizuka E
Department of Urology, Yokohama City Kouwan Hospital.
Hinyokika Kiyo. 1998 Dec;44(12):875-8.
Two cases of major blunt renal trauma with urinary extravasation managed by conservative treatment are presented herein. The first case: A 13-year-old girl fell from a bicycle. A computed tomographic (CT) scan showed right renal laceration with retroperitoneal hematoma. Renal arteriography showed evidence of fresh arterial bleeding without visualization of the lower pole. She was treated conservatively with superselective arterial embolization of the lower pole. She developed no urinoma with normal renal function. Renal renin and blood pressures stayed within the normal range in follow up studies. The second case: A 12-year-old boy fell from a tree and hit his right flank. A CT scan showed fragmentation of right renal cortex with retroperitoneal hematoma. He was treated conservatively as his vital signs remained stable, no active arterial bleeding was found no renal arteriography and both renal pelvis and ureters were well visualized by intra venous pyelography. Retroperitoneal hematoma was absorbed without formation of urinoma. Renal function remained within normal limits in follow up studies.
本文介绍了两例通过保守治疗处理的伴有尿外渗的严重钝性肾外伤病例。第一例：一名13岁女孩从自行车上摔下。计算机断层扫描（CT）显示右肾撕裂伤伴腹膜后血肿。肾动脉造影显示有新鲜动脉出血，但下极未显影。对其下极进行超选择性动脉栓塞保守治疗。她未形成尿瘤，肾功能正常。随访研究中肾素和血压保持在正常范围内。第二例：一名12岁男孩从树上摔下，撞到右侧胁腹。CT扫描显示右肾皮质碎裂伴腹膜后血肿。由于其生命体征稳定，未发现活动性动脉出血，未进行肾动脉造影，静脉肾盂造影显示肾盂和输尿管均正常，故对其进行保守治疗。腹膜后血肿被吸收，未形成尿瘤。随访研究中肾功能保持在正常范围内。
