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经导管动脉栓塞术治疗前列腺穿刺活检后前列腺动脉出血

[Transcatheter arterial embolization for bleeding of prostatic artery after prostate biopsy].

作者信息

Kaneko Takuji, Suzuki Toru, Matsushita Nozomi, Yoshida Ikuhiko

机构信息

Department of Urology, Iwate Prefectural Kuji Hospital.

出版信息

Nihon Hinyokika Gakkai Zasshi. 2003 Nov;94(7):693-5. doi: 10.5980/jpnjurol1989.94.693.

Abstract

We present a case of bleeding from the prostatic artery, complicating transrectal ultrasound (TRUS) guided prostate needle biopsy, that responded to transcatheter arterial embolization (TAE). A 62-year-old man with a serum PSA of 4.1 ng/ml was admitted to this institution for a prostate biopsy. He developed hypotension and marked abdominal distension 3 hours after undergoing TRUS guided prostate needle biopsy. CT scanning revealed a massive hematoma extending from the pelvis into the retroperitoneal space. Intra-arterial digital subtraction angiography (IA-DSA) showed extravasation of dye from the right prostatic artery, indicating that it had been damaged during the biopsy procedure. The bleeding was successfully stopped with TAE, using 6 micro coils. TRUS guided prostate biopsy is generally considered a safe procedure, with few complications, and cases of massive hemorrhage into the retroperitoneal space are extremely rare. In cases of arterial retroperitoneal bleeding such as this one, treatment with TAE is fast and accurate.

摘要

我们报告一例前列腺动脉出血病例,该病例为经直肠超声(TRUS)引导下前列腺穿刺活检的并发症,经导管动脉栓塞术(TAE)治疗有效。一名血清前列腺特异抗原(PSA)为4.1 ng/ml的62岁男性因前列腺活检入住本院。他在接受TRUS引导下前列腺穿刺活检3小时后出现低血压和明显腹胀。CT扫描显示巨大血肿从盆腔延伸至腹膜后间隙。动脉数字减影血管造影(IA-DSA)显示右侧前列腺动脉有造影剂外渗,表明其在活检过程中受损。使用6个微线圈行TAE成功止血。TRUS引导下前列腺活检通常被认为是一种安全的操作,并发症较少,而腹膜后间隙大量出血的病例极为罕见。对于此类动脉性腹膜后出血病例,TAE治疗快速且准确。

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