Vergos M, Singland J D, Chapuis O, Bauchu J Y, Andre J L
Service de Chirurgie Viscérale et Vasculaire, H.I.A. Begin, Saint-Mande.
J Urol (Paris). 1992;98(4):221-4.
Lesions of the ureter caused by penetrating wounds of the abdomen rare a are complication of abdominal gunshot wounds, of which the reported incidence is 2 to 17%. The preoperative diagnosis is difficult and unrecognized initially in every third case. There are no early clinical signs of ureteral lesions. There is often no hematuria. Only IVP can male the preoperative diagnosis possible. As a matter of fact, the diagnosis will often be established by the surgical exploration made during the laparotomy required by the extent of the associated lesions. The ureteral blast contusion is an important cause of secondary necrosis with fistula. The treatment is mainly based on ureteroureterostomy after debridement. The transanasmotic drainage of urine is controversial. Mortality results from associated abdominal lesions and morbidity consists in a risk of secondary nephrectomy.
腹部穿透伤所致输尿管损伤是腹部枪伤的一种罕见并发症，据报道其发生率为2%至17%。术前诊断困难，每三例中就有一例最初未被识别。输尿管损伤没有早期临床症状。通常没有血尿。只有静脉肾盂造影（IVP）才能实现术前诊断。事实上，诊断往往是在因相关损伤程度而进行剖腹手术时通过手术探查确立的。输尿管爆震伤是继发性坏死伴瘘的重要原因。治疗主要基于清创术后的输尿管输尿管吻合术。经鼻输尿管引流尿液存在争议。死亡源于相关的腹部损伤，发病则在于二次肾切除术的风险。
