Alster C, Zantut L F C, Lorenzi F, Marchini G S, Onofrio B J M, Nakashima A A, Gatto B E O, Birolini D
University of Sao Paolo, Sao Paolo, SP 05410-020, Brazil.
Br J Radiol. 2007 Jan;80(949):e1-3. doi: 10.1259/bjr/65194982.
Gastrointestinal perforations usually lead to pneumoperitoneum and peritonitis. Rarely, if ever described, a complete giant staghorn renal stone might cause a nephrocolic fistula with sigmoid impaction and perforation similar to gallstone ileus. Few nephrointestinal fistulae have been described in the literature and none of them were presented as an acute abdomen with pneumoperitoneum and pneumoretroperitoneum. To our knowledge, this is the only case showing CT and radiographic findings of a pathology not yet described in the literature. We named the sigmoid perforation by a renal stone ileus "Lorenzi's syndrome" after the physician who hypothesized this rare differential diagnosis based only on history and clinical examination.
胃肠道穿孔通常会导致气腹和腹膜炎。很少见，如果有描述的话，完整的巨大鹿角形肾结石可能会导致肾结肠瘘，伴有乙状结肠嵌顿和穿孔，类似于胆石性肠梗阻。文献中很少描述肾肠瘘，且均未表现为伴有气腹和腹膜后积气的急腹症。据我们所知，这是唯一一例显示出文献中尚未描述的病理的CT和影像学表现的病例。我们以一位仅根据病史和临床检查就推测出这种罕见鉴别诊断的医生的名字，将由肾结石性肠梗阻导致的乙状结肠穿孔命名为“洛伦齐综合征”。
