Molina Escudero R, Cancho Gil M J, Husillos Alonso A, Lledó García E, Herranz Amo F, Ogaya Piniés G, Ramón Botella E, Simó G, Navas Martínez M C, Hernández Fernández C
Department of Urology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. robersescu @ hotmail.com
Urol Int. 2012;88(1):112-4. doi: 10.1159/000330800. Epub 2011 Sep 17.
We present the case of a 25-year-old male who came to the emergency room for pain and abdominal distension following trauma to the mesogastrium. A CT scan was performed, revealing a voluminous retroperitoneal hematoma with laceration of both inferior renal poles with regard to rupture of the isthmus of a horseshoe kidney. The patient presented anemization and increased pain, requiring selective embolization by means of arteriography of a branch of the right renal artery and placement of a double J stent due to urinary extravasation in the lower left kidney pole. Following 1 year of monitoring, the patient has maintained normal renal function. Renal affection in blunt abdominal trauma is frequent, occurring in 7% of previously pathological kidneys. The traumatic rupture of horseshoe kidney is facilitated by its particular anatomical characteristics, constituting an infrequent entity, knowledge of which is necessary to achieve conservative management that renders it possible to preserve renal function.
我们报告一例25岁男性病例，该患者因中腹部外伤后出现疼痛和腹胀前来急诊室。进行了CT扫描，结果显示巨大的腹膜后血肿，伴有马蹄肾峡部破裂导致双侧肾下极撕裂。患者出现贫血且疼痛加剧，因左肾下极尿外渗，需要通过右肾动脉分支动脉造影进行选择性栓塞并放置双J支架。经过1年的监测，患者肾功能维持正常。钝性腹部外伤导致的肾损伤很常见，在既往有病理改变的肾脏中发生率为7%。马蹄肾因其特殊的解剖结构，更容易发生创伤性破裂，这是一种罕见的情况，了解这一点对于实现保守治疗并保留肾功能至关重要。
