Zajaczkowski T, Straube W, Kissler W, Schumacher T, de Dycker R P
Urologische Abteilung, Marienhospital, Essen.
Urologe A. 1990 Sep;29(5):256-60.
Two cases of spontaneous rupture of the kidney are reported and the literature is reviewed. The clinical and pathological features of this uncommon disease and its treatment are discussed. In the first case the cause of retroperitoneal bleeding was a renal carcinoma, while in the second it was the result of renal metastases from gestational trophoblastic disease. The most common symptoms are an acute onset of flank or abdominal pain, macroscopic hematuria and a drop in the hemoglobin level. Resistance or a mass can be palpated. Ultrasound and radiological examinations allow visualization of a tumor or hematoma and mostly reveal the etiology of hemorrhage. An exploratory operation is necessary for diagnosis, and primary nephrectomy should be seriously considered.
报告了两例肾自发性破裂病例并对文献进行了综述。讨论了这种罕见疾病的临床和病理特征及其治疗方法。第一例中,腹膜后出血的原因是肾癌,而第二例是妊娠滋养细胞疾病肾转移的结果。最常见的症状是突发侧腹或腹痛、肉眼血尿和血红蛋白水平下降。可触及肿块或抵抗感。超声和放射学检查可显示肿瘤或血肿,并大多能揭示出血的病因。诊断需要进行探查手术,应认真考虑行一期肾切除术。