Dees A, Kluchert S A, van Vliet A C
Department of Internal Medicine, Diakonessenhuis Refaja, Dordrecht.
Neth J Med. 1990 Dec;37(5-6):197-201.
Three patients with internal leakage of urine are described. As a result of urine resorption into the blood a condition developed resembling acute renal failure. Internal loss of urine is divided into intraperitoneal and extraperitoneal leakage and usually gives rise to oliguria and microscopic haematuria. In the intraperitoneal type increasing abdominal complaints and ascites will develop whereas in the extraperitoneal type regional oedema will become present without, in the case of sterile urine, abdominal complaints of importance. Important clues as to the diagnosis are the concentrations in serum and urine of urea, creatinine and sodium, and the demonstration of the leak by means of imaging techniques. Treatment of choice is a drainage procedure, for instance by a bladder catheter. In acute renal failure this pseudo form should be distinguished from the real thing.
本文描述了3例尿液内漏患者。由于尿液重吸收进入血液,出现了类似急性肾衰竭的情况。尿液内漏分为腹腔内和腹膜外漏,通常会导致少尿和镜下血尿。腹腔内型会出现腹部症状加重和腹水,而腹膜外型会出现局部水肿,在无菌尿液的情况下,腹部症状不明显。诊断的重要线索是血清和尿液中尿素、肌酐和钠的浓度,以及通过影像学技术显示漏出情况。首选治疗方法是引流手术,例如通过膀胱导管引流。在急性肾衰竭中,应将这种假性形式与真正的急性肾衰竭区分开来。