Kamada K, Yoshihiro S, Matsuyama H, Takihara H, Naito K, Yasui H
Department of Urology, Yamaguchi University School of Medicine.
Hinyokika Kiyo. 1992 Jul;38(7):829-32.
Three cases of spontaneous peripelvic extravasation after the operation of rectal cancer are reported. In case 1, a 65-year-old female complained of left flank pain one month after high-anterior resection for rectal cancer. Drip infusion pyelography (DIP) and retrograde pyelography (RP) showed extravasation from the left renal pelvis. The ureteral stent was indwelled, and the extravasation showed remission. In case 2, a 55-year-old female complained of left lumbago 6 months after Miles' operation for rectal cancer. DIP showed extravasation from the left renal pelvis. The same findings were confirmed on the repeated DIP after 10 days. The ureteral stent was indwelled, and the extravasation was cured. In case 3, a 69-year-old male complained of left flank pain and left abdominal tumor 10 months after Miles' operation for rectal cancer. DIP and RP showed extravasation from the right renal pelvis, and computed tomographic (CT) scan showed urinoma formation. Drainage of the urinoma was performed and the ureteral stent was indwelled. The urinoma and the extravasation was cured. We emphasized the usefulness of indwelling the ureteral stent for the conservative management of spontaneous peripelvic extravasation caused by a malignant tumor, and a discussion of the relevant literature follows.
本文报告了3例直肠癌手术后自发性肾盂周围外渗的病例。病例1,一名65岁女性在直肠癌高位前切除术后1个月出现左侧腰痛。静脉肾盂造影(DIP)和逆行肾盂造影(RP)显示左肾盂外渗。留置输尿管支架后,外渗情况缓解。病例2,一名55岁女性在直肠癌Miles手术后6个月出现左腰痛。DIP显示左肾盂外渗。10天后重复DIP检查证实了相同的结果。留置输尿管支架后,外渗得以治愈。病例3,一名69岁男性在直肠癌Miles手术后10个月出现左侧腰痛和左腹部肿块。DIP和RP显示右肾盂外渗,计算机断层扫描(CT)显示尿瘤形成。进行了尿瘤引流并留置输尿管支架。尿瘤和外渗均得以治愈。我们强调了留置输尿管支架在保守治疗恶性肿瘤引起的自发性肾盂周围外渗中的作用,并对相关文献进行了讨论。