Geldof K, Maleux G, Heye S, Van Cleynenbreugel B, Oyen R
Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium.
JBR-BTR. 2008 Sep-Oct;91(5):203-5.
Lumbar arterial bleedings are rare but potentially life threatening. We report a case of an isolated right lumbar arterial bleeding after radical nephrectomy for renal infarction with infected perirenal haematoma. The diagnosis was suggested by computed tomography and confirmed with angiography. Definitive treatment of this vascular injury was obtained after percutaneous transcatheter embolization of the fourth right lumbar artery. General anaesthesia, further blood loss due to difficult surgical dissection, or even failure to find and ligate the injured artery, especially in redo-operations, can be avoided by this minimal invasive procedure. Endovascular embolization of a lumbar artery injured after radical nephrectomy might be a valuable treatment alternative in patients with postoperative retroperitoneal bleeding.
腰动脉出血罕见但可能危及生命。我们报告一例肾梗死伴感染性肾周血肿行根治性肾切除术后孤立性右腰动脉出血的病例。计算机断层扫描提示诊断,并经血管造影证实。经皮经导管栓塞右侧第四腰动脉后,对该血管损伤进行了确定性治疗。这种微创手术可避免全身麻醉、因手术解剖困难导致的进一步失血,甚至避免在再次手术中找不到并结扎受损动脉的情况。根治性肾切除术后腰动脉损伤的血管内栓塞可能是术后腹膜后出血患者一种有价值的治疗选择。