Shimizu Kanichiro, Mogami Takuji, Michimoto Kenkichi, Kameoka Yoshihiko, Tokashiki Tadashi, Kurata Naoki, Miki Jun, Kishimoto Koichi
Department of Radiology, Kashiwa Hospital, The Jikei University School of Medicine, Chiba, Japan.
Department of Radiology, Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.
Cardiovasc Intervent Radiol. 2016 Jan;39(1):122-6. doi: 10.1007/s00270-015-1110-7. Epub 2015 May 6.
We report a case each of duodenorenal and colorenal fistula that arose after computed tomography-guided percutaneous cryoablation (PCA) for renal cell carcinoma and use imaging and endoscopic findings to analyze their causes and mechanisms. Both complications occurred though the edge of the iceball did not touch the intestinal wall, and patients' symptoms and fistula formation occurred several days after the PCA procedure. Based on imaging and endoscopy findings, we suspected the colorenal fistula resulted from bowel injury caused by ischemia from the occlusion of small vessels at the procedure's low temperature. Both cases were resolved conservatively without surgical intervention.
我们报告了两例在计算机断层扫描引导下经皮冷冻消融术（PCA）治疗肾细胞癌后出现十二指肠肾瘘和结肠肾瘘的病例，并利用影像学和内镜检查结果分析其病因和机制。尽管冰球边缘未接触肠壁，但两种并发症均发生了，且患者症状和瘘管形成均出现在PCA术后数天。根据影像学和内镜检查结果，我们怀疑结肠肾瘘是由于手术低温导致小血管闭塞引起的缺血性肠损伤所致。两例均经保守治疗痊愈，未进行手术干预。
