Raft J, Lalot J-M, Meistelman C, Longrois D
Département d'anesthésie-réanimation chirurgicale, CHU de Nancy-Brabois, 4, rue du Morvan, 54511 Vandoeuvre-lès-Nancy, France.
Gynecol Obstet Fertil. 2006 Oct;34(10):917-9. doi: 10.1016/j.gyobfe.2006.02.021. Epub 2006 Sep 25.
A 40 year-old 2nd gesta pregnant woman (34.5 weeks of amenorhea) was admitted to hospital for abdominal pain and arterial hypotension which were rapidly related to a retroperitoneal haematoma due to left kidney bleeding. Emergency cesarean delivery under general anaesthesia was undertaken because of foetal distress. Exploration of the retroperitonal space after foetal extraction confirmed the presence of a large haematoma and abnormal left renal morphology. The retroperitoneal space was drained without any further intervention. Subsequently, abdominal and thoracic computerised tomographic examination showed bilateral dysplasia of the kidneys and pulmonary cysts consistent with the diagnosis of renal angiomyolipoma and pulmonary lymphangioleiomyomatosis. The case report is of interest because of the circumstances of discovery of the disease and because nephrectomy was not necessary to control the bleeding of the left kidney. Six months after the incident the patient and the child are in good condition.
一名40岁的经产妇(停经34.5周)因腹痛和动脉低血压入院,这些症状很快被发现与左肾出血导致的腹膜后血肿有关。由于胎儿窘迫,在全身麻醉下进行了紧急剖宫产。胎儿娩出后对腹膜后间隙进行探查,证实存在巨大血肿以及左肾形态异常。对腹膜后间隙进行了引流,未进行进一步干预。随后,腹部和胸部计算机断层扫描显示双侧肾发育异常和肺囊肿,符合肾血管平滑肌脂肪瘤和肺淋巴管平滑肌瘤病的诊断。该病例报告因其疾病发现情况以及控制左肾出血无需进行肾切除术而具有意义。事件发生六个月后,患者和孩子状况良好。