Philipoff Adam Carl, Ramsay Duncan, Weber Dieter G
Department of Trauma & General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia.
BMJ Case Rep. 2017 Jan 4;2017:bcr2016216795. doi: 10.1136/bcr-2016-216795.
Abdominal angiography with selective arteriography and subsequent embolisation is an accepted management modality in the treatment of selected solid organ injuries following blunt abdominal trauma. This management practice is well established in the haemodynamically stable patient; however, this remains more controversial in haemodynamically compromised patients, though warrants consideration in both cases due to the associated benefits of non-operative management. This case report describes the successful non-operative management of a severe renal injury in a young polytraumatised patient following a high-speed motor vehicle crash. In addition, the rare CT diagnosis and management of an acute traumatic arteriocalcyeal fistula is discussed with a focus on the importance of renal parenchymal preservation.
腹部血管造影联合选择性动脉造影及后续栓塞术是钝性腹部创伤后特定实体器官损伤治疗中公认的管理方式。这种管理方法在血流动力学稳定的患者中已得到充分确立；然而，在血流动力学不稳定的患者中仍存在更多争议，不过鉴于非手术治疗的相关益处，在这两种情况下都值得考虑。本病例报告描述了一名年轻多发伤患者在高速机动车碰撞后严重肾损伤的成功非手术治疗。此外，还讨论了急性创伤性动脉肾盂瘘的罕见CT诊断和治疗，重点强调了保留肾实质的重要性。
