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钝性创伤继发孤立性肾盂破裂:病例报告

Isolated renal pelvis rupture secondary to blunt trauma: Case report.

作者信息

Taken Kerem, Oncü Mehmet Reşit, Ergün Müslüm, Eryılmaz Recep, Güneş Mustafa

机构信息

Urology Department of Medicine Faculty, Yüzüncü Yıl University, Van, Turkey.

Emergency Department of Medicine Faculty, Yüzüncü Yıl University, Turkey.

出版信息

Int J Surg Case Rep. 2015;9:82-4. doi: 10.1016/j.ijscr.2015.02.044. Epub 2015 Feb 26.

Abstract

INTRODUCTION

Isolated rupture of the renal pelvis is a very rare condition and thus causes delays in the diagnosis of the rupture. It is most commonly seen in the setting of obstructive ureteric calculus. Other rare causes include neoplasms, trauma, and iatrogenic procedures. Diagnosis is usually established on computed tomography (CT) which demonstrates the extravasation of the contrast in the peripelvic, perinephric, or retroperitoneal collections.

PRESENTATION OF CASE

A 27-year-old male patient was admitted to our hospital due to multiple traumas associated with motor vehicle accidents. The patient had clear urine output. A large pelvic rupture was detected by abdominal contrast-enhanced CT and after consulting with other departments, emergency repair of the renal pelvis was performed and a ureteral stent was implanted.

DISCUSSION

Only a few isolated cases of pelvis rupture with resultant extravasation have been reported in the literature. The treatment of pelvic rupture should be preceded by the removal of underlying causes, followed by conservative management. However, surgical intervention should be warranted in the emergency cases presenting with the symptoms that may impede the decision-making process and in the cases whose diagnosis cannot be clarified by radiological techniques.

CONCLUSION

Renal pelvic injury must be considered in the differential diagnosis of blunt trauma. Surgical intervention may be necessary in some cases. We present a case who underwent surgery due to isolated renal pelvis rupture caused by blunt abdominal trauma.

摘要

引言

肾盂孤立性破裂是一种非常罕见的病症,因此会导致破裂诊断的延迟。它最常见于输尿管梗阻性结石的情况下。其他罕见原因包括肿瘤、创伤和医源性操作。诊断通常通过计算机断层扫描(CT)来确定,CT显示造影剂在肾盂周围、肾周或腹膜后间隙聚集处外渗。

病例介绍

一名27岁男性患者因机动车事故导致多处创伤入院。患者尿量正常。腹部增强CT检查发现巨大肾盂破裂,经多科室会诊后,对肾盂进行了急诊修复,并植入了输尿管支架。

讨论

文献中仅报道了少数几例伴有外渗的孤立性肾盂破裂病例。肾盂破裂的治疗应先去除潜在病因,然后进行保守治疗。然而,对于出现可能妨碍决策过程的症状的急诊病例以及无法通过放射学技术明确诊断的病例,应进行手术干预。

结论

在钝性创伤的鉴别诊断中必须考虑肾盂损伤。在某些情况下可能需要手术干预。我们报告了一例因钝性腹部创伤导致孤立性肾盂破裂而接受手术的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c17/4392341/59f71126cff6/gr1.jpg

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