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腹腔镜下肾错构瘤部分肾切除术后肾动脉假性动脉瘤的栓塞治疗:病例报告及文献复习

Embolization of renal-artery pseudoaneurysm after laparoscopic partial nephrectomy for angiomyolipoma: case report and literature review.

作者信息

Zorn Kevin C, Starks Christopher L, Gofrit Ofer N, Orvieto Marcelo A, Shalhav Arieh L

机构信息

Section of Urology, University of Chicago Pritzker School of Medicine, Chicago, Illinois 60637, USA.

出版信息

J Endourol. 2007 Jul;21(7):763-8. doi: 10.1089/end.2006.0332.

Abstract

BACKGROUND

Renal-artery pseudoaneurysm (RAP) is a well-described complication of trauma or percutaneous urologic procedures. Delayed bleeding from an RAP is rare after partial nephrectomy.

CASE REPORT

We present a 49-year-old woman who, 24 days after undergoing a laparoscopic right partial nephrectomy for a mesophytic 2.5-cm tumor, developed gross hematuria. Prompt CT imaging, followed by therapeutic angio-embolization of a third-order segmental renal artery with coils, treated the pseudoaneurysm successfully.

CONCLUSIONS

Renal-artery pseudoaneurysm is a rare, potentially life-threatening, condition that often is difficult to diagnose and requires a high index of clinical suspicion. Early use of selective angio-embolization minimizes morbidity and maximizes renal conservation. The etiology, diagnosis, and management are discussed.

摘要

背景

肾动脉假性动脉瘤(RAP)是创伤或经皮泌尿外科手术中一种广为人知的并发症。肾部分切除术后,RAP延迟出血较为罕见。

病例报告

我们报告一名49岁女性,在因2.5 cm中生型肿瘤接受腹腔镜右肾部分切除术后24天出现肉眼血尿。及时进行CT成像,随后用弹簧圈对三级节段性肾动脉进行治疗性血管栓塞,成功治疗了假性动脉瘤。

结论

肾动脉假性动脉瘤是一种罕见的、可能危及生命的疾病,通常难以诊断,需要高度的临床怀疑指数。早期使用选择性血管栓塞可将发病率降至最低,并最大限度地保留肾脏。本文讨论了其病因、诊断和治疗方法。

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