Machuca Santa Cruz J, Julve Villalta E, Galacho Bech A, Pérez Rodríguez D, Quiñonero Díaz A, Alonso Dorrego J M, Marín Martín J A
Servicio de Urología, Hospital Clínico Virgen de la Victoria, Málaga.
Actas Urol Esp. 1999 Jan;23(1):43-50.
We report 15 cases of spontaneous retroperitoneal haematoma. The etiology and the diagnostic and therapeutic procedures were evaluated. The haematoma source was the adrenal gland in 4 patients and the causes were pheochromocytoma (1), adenoma (1), myelolipoma (1) and idiopathic (1). In 10 patients the source was the kidney and the causes were angiomyolipoma rupture (6), renal cell carcinoma (3) and ureteral calculi (1). In the remaining case, the haematoma was produced by fibrinolytic and anticoagulant therapy in a patient with acute myocardial infarction. The imaging diagnostic techniques employed were abdominal ultrasonography and CT scan, which allowed the diagnosis of haematoma and showed his size and extension in all the cases. With these two techniques, and with the retrograde pyelography in one patient, we obtained the etiologic diagnosis in 12 of the 15 cases. Surgical treatment was performed in 12 patients (adrenalectomy in 2, simple nephrectomy in 3, radical nephrectomy in 5 and partial nephrectomy in 2).
我们报告了15例自发性腹膜后血肿病例。对其病因及诊断和治疗方法进行了评估。血肿来源为肾上腺的有4例患者，病因分别为嗜铬细胞瘤（1例）、腺瘤（1例）、髓样脂肪瘤（1例）和特发性（1例）。10例患者的血肿来源为肾脏，病因分别为血管平滑肌脂肪瘤破裂（6例）、肾细胞癌（3例）和输尿管结石（1例）。在其余1例中，血肿是由一名急性心肌梗死患者接受纤溶和抗凝治疗引起的。所采用的影像学诊断技术为腹部超声检查和CT扫描，这两项检查在所有病例中均能诊断出血肿并显示其大小和范围。通过这两种技术，以及对1例患者进行的逆行肾盂造影，我们在15例病例中的12例中做出了病因诊断。12例患者接受了手术治疗（2例行肾上腺切除术，3例行单纯肾切除术，5例行根治性肾切除术，2例行部分肾切除术）。
