Woittiez Karen J, van Buren Marjolijn, Kesecioglu Jozef
Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
BMJ Case Rep. 2012 Aug 13;2012:bcr2012006499. doi: 10.1136/bcr-2012-006499.
In this case report, a patient is described with an unusual cause of renal artery stenosis (RAS). The patient presented with acute anuric renal failure and hypertensive urgency, following a nephrectomy, which was complicated by massive blood loss. Because the acute renal failure was first presumed to be due to acute tubular necrosis, the diagnosis of a nearly complete iatrogenic RAS was not made until 6 weeks after surgery. The stenosis was caused by five misplaced surgical clips on the artery of the remaining kidney. The hypertension was initially treated with ACE inhibitor. Eight weeks after the initial surgery, a successful revascularisation procedure was performed, leading to the recovery of kidney function.
在本病例报告中，描述了一名患有肾动脉狭窄（RAS）罕见病因的患者。该患者在肾切除术后出现急性无尿性肾衰竭和高血压急症，手术并发大量失血。由于急性肾衰竭最初被认为是由急性肾小管坏死所致，直到术后6至14周才诊断出几乎完全性的医源性RAS。狭窄是由剩余肾脏动脉上五个位置不当的手术夹引起的。高血压最初用血管紧张素转换酶抑制剂治疗。初次手术后八周，进行了一次成功的血管重建手术，使肾功能得以恢复。
