Doehn C, Fiola L, Peter M, Jocham D
Klinik und Poliklinik für Urologie, Universitätsklinikum Schleswig-Holstein (UK S-H), Campus Lübeck.
Aktuelle Urol. 2010 Mar;41(2):119-21. doi: 10.1055/s-0030-1247252. Epub 2010 Feb 9.
Fornix rupture is a urological emergency situation. In most cases ureteral stones represent the underlying cause. We present the largest series ever reported.
Between 1994 bis 2005 a total of 162 patients were diagnosed with a fornix rupture. There were 121 men and 41 women with a median age of 53 years (range: 20-79 years). We investigated the following parameters: underlying cause of fornix rupture, symptoms, diagnostic and therapeutic procedures.
In 60% of cases a ureteral stone was found as cause and in another 28% we found no reason for fornix rupture. 93% of patients had one or more symptoms at the time of diagnosis. In all patients primary endoscopic therapy (96%) or insertion of a nephrostomy tube was performed (4%). Also, antibiotic treatment was given in 92% of patients. No patient developed a perirenal abscess or other relevant complication requiring open operative revision.
We confirm that ureteral stones are the most frequent causes of fornix rupture. With a low pressure system and antibiotic treatment, secondary complications can be effectively prevented.
穹窿破裂是一种泌尿外科急症。在大多数情况下,输尿管结石是其根本原因。我们呈现了迄今为止报道的最大病例系列。
1994年至2005年间,共有162例患者被诊断为穹窿破裂。其中男性121例,女性41例,中位年龄53岁(范围:20 - 79岁)。我们调查了以下参数:穹窿破裂的根本原因、症状、诊断和治疗方法。
60%的病例中发现输尿管结石是病因,另外28%的病例未发现穹窿破裂的原因。93%的患者在诊断时出现一种或多种症状。所有患者均接受了一期内镜治疗(96%)或置入肾造瘘管(4%)。此外,92%的患者接受了抗生素治疗。没有患者发生肾周脓肿或其他需要开放手术翻修的相关并发症。
我们证实输尿管结石是穹窿破裂最常见的原因。通过低压系统和抗生素治疗,可以有效预防继发性并发症。