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慢性脊髓损伤患者排尿性膀胱尿道造影时造影剂外渗:一例报告

Extravasation of the Contrast Material During Voiding Cystourethrography in a Chronic Spinal Cord Injury Patient: A Case Report.

作者信息

Kwon Sohyun, Park Donghwi, Lee Hoon Hoon, Ryu Ju Seok

机构信息

Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Korea.

出版信息

Ann Rehabil Med. 2017 Apr;41(2):323-327. doi: 10.5535/arm.2017.41.2.323. Epub 2017 Apr 27.

Abstract

Neurogenic bladder is common in most spinal cord injury patients. Voiding cystourethrography (VCUG) is recommended in these patients to detect urinary tract complications. However, rare but serious complications may occur during VCUG, although VCUG is generally safe. There are several case reports of bladder rupture occurring in pediatric patients. Here, we report the first case of iatrogenic bladder rupture in an adult spinal cord injury patient in Korea. Particularly, extravasation of contrast without manual instillation has hardly ever been reported. To the best of our knowledge, this is the first reported case of bladder rupture without manual instillation during VCUG. We report a case of a 59-year-old female with paraplegia due to tuberculous spondylitis who underwent VCUG as a part of routine evaluation of neurogenic bladder. Extravasation of the contrast media during VCUG developed as a complication and the patient recovered spontaneously without any intervention. Therefore, VCUG should be performed properly in chronic spinal cord injury patients.

摘要

神经源性膀胱在大多数脊髓损伤患者中很常见。建议对这些患者进行排尿性膀胱尿道造影(VCUG)以检测泌尿系统并发症。然而,尽管VCUG一般是安全的,但在检查过程中可能会发生罕见但严重的并发症。有几例关于小儿患者膀胱破裂的病例报告。在此,我们报告韩国首例成年脊髓损伤患者医源性膀胱破裂的病例。特别是,在没有手动灌注的情况下造影剂外渗几乎从未被报道过。据我们所知,这是首例报道的在VCUG期间没有手动灌注而发生膀胱破裂的病例。我们报告一例59岁因结核性脊柱炎导致截瘫的女性患者,其作为神经源性膀胱常规评估的一部分接受了VCUG检查。VCUG期间造影剂外渗作为一种并发症出现,患者未经任何干预自行康复。因此,对于慢性脊髓损伤患者应正确进行VCUG检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebc0/5426255/9b26f38c5863/arm-41-323-g001.jpg

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