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[经皮输尿管造口术与腹壁下动脉之间形成瘘管导致大出血:一例报告]

[MASSIVE HEMORRHAGE FROM THE FISTULA FORMATION BETWEEN CUTANEOUS URETEROSTOMY AND INFERIOR EPIGASTRIC ARTERY: A CASE REPORT].

作者信息

Fujinami Hiroyuki, Shibuya Tadamasa, Mori Kenichi, Shin Toshitaka, Sumino Yasuhiro, Sato Fuminori, Mimata Hiromitsu, Sato Yoshiyasu, Matsubara Takanori, Sakamoto Sadaaki, Kamei Noritaka, Hongo Tetsuo

出版信息

Nihon Hinyokika Gakkai Zasshi. 2015 Apr;106(2):127-31. doi: 10.5980/jpnjurol.106.127.

Abstract

A 87-year-old man received radical nephroureterectomy for right renal pelvic cancer in 2009 and left cutaneous ureterostomy after radical cystectomy for bladder cancer in 2013. He visited the hospital for exchanging a 7 or 8 Fr single-J catheter every 2 to 4 weeks. Eleven months after the 2nd operation, massive bleeding from the stoma occurred when ureteral catheter was exchanged. Contrast-enhanced computed tomography showed that left inferior epigastric artery was located close to left ureter. Angiography of the left inferior epigastric artery didn't show an obvious fistula, but revealed the stoma was surrounded by ramified new blood vessels from left inferior epigastric artery. We suspected a rupture of the vessels and performed embolization for the branch of inferior epigastric artery to left ureter. This embolization made it possible for the bleeding to be controlled. Massive bleeding from the branch of inferior epigastric artery is very rare, and we report the case and review the literature.

摘要

一名87岁男性于2009年接受了右肾盂癌根治性肾输尿管切除术,并于2013年在膀胱癌根治性膀胱切除术后行左皮肤输尿管造口术。他每2至4周来医院更换一次7或8Fr的单J导管。第二次手术后11个月,在更换输尿管导管时造口处发生大量出血。增强计算机断层扫描显示左腹壁下动脉靠近左输尿管。左腹壁下动脉血管造影未显示明显瘘管,但显示造口被来自左腹壁下动脉的分支新生血管包围。我们怀疑血管破裂,对左输尿管的腹壁下动脉分支进行了栓塞。这次栓塞使出血得到了控制。腹壁下动脉分支大量出血非常罕见,我们报告该病例并复习文献。

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