Jou Yeong-Chin, Chen Wen-Pin, Huang Chun-Lin
Department of Urology, Chiayi Christian Hospital, Chiayi, Taiwan, R.O.C.
J Chin Med Assoc. 2009 Aug;72(8):450-2. doi: 10.1016/S1726-4901(09)70405-8.
Tumor rupture with hemorrhage is a severe complication of renal angiomyolipoma. Urgent transcatheter arterial embolization is an effective method for the patient suffering from life-threatening hemorrhage due to ruptured angiomyolipoma. Elective surgery has been suggested because of the possibility of rebleeding or abscess formation after embolization. However, it is not easy to perform a nephron-sparing procedure by delayed elective surgery due to severe tissue adhesion after bleeding. Herein, we report 2 cases of ruptured renal angiomyolipoma initially managed with transcatheter arterial embolization. Nephron-sparing surgery was performed a few days after embolization, before tissue adhesion occurred. Both kidneys were preserved, and the postoperative course was uneventful.
肿瘤破裂出血是肾血管平滑肌脂肪瘤的一种严重并发症。对于因血管平滑肌脂肪瘤破裂而出现危及生命的出血的患者,紧急经导管动脉栓塞术是一种有效的治疗方法。由于栓塞后有再出血或脓肿形成的可能,有人建议进行择期手术。然而,由于出血后组织粘连严重,通过延迟择期手术进行保留肾单位手术并不容易。在此,我们报告2例肾血管平滑肌脂肪瘤破裂患者,最初采用经导管动脉栓塞术治疗。在栓塞后几天,在组织粘连发生之前进行了保留肾单位手术。两个肾脏均得以保留,术后过程顺利。