Singh Varinder, Jayaram Sreenivas, Kumar Dhananjaya Br
Senior Resident, Department of MCH Urology, Institute of Nephrourology, Bangaluru, Karnataka, India.
Associate Professor, Department of MCH Urology, Institute of Nephrourology, Bangaluru, Karnataka, India.
J Clin Diagn Res. 2017 Aug;11(8):PD13-PD14. doi: 10.7860/JCDR/2017/27901.10435. Epub 2017 Aug 1.
Spontaneous subcapsular renal haematoma is a rare condition with wide range of presentation; it poses a dilemma for diagnosis and management. We present a case of 38-year-old female who presented with right flank pain (continuous, dull aching) for a week with right renal angle tenderness and high blood pressure (though she was not known hypertensive). On imaging, there was right renal subcapsular collection. She did not respond to conservative management except that her blood pressure was controlled with single drug Angiotensin Converting Enzyme (ACE) inhibitor. Right double J stent was placed (in view of urinoma) and patient was followed for six weeks. Repeat computed tomography scan showed persistence of right renal subcapsular collection but the cause was not found. Except hypertension, no definitive cause for the condition could be found. Patient was intervened surgically with right subcostal exploration and subcapsular haematoma was found and drained. Patient was asymptomatic thereafter.
自发性肾包膜下血肿是一种罕见病症,临床表现多样;其诊断和治疗颇具难题。我们报告一例38岁女性患者,她出现右侧胁腹疼痛(持续性钝痛)一周,伴有右肾角压痛和高血压(尽管她既往无高血压病史)。影像学检查显示右肾包膜下有积液。除了使用单一药物血管紧张素转换酶(ACE)抑制剂控制血压外,她对保守治疗无反应。鉴于存在尿囊肿,放置了右侧双J管,并对患者进行了六周的随访。重复计算机断层扫描显示右肾包膜下积液持续存在,但病因未明。除高血压外,未发现该病症的确切病因。患者接受了手术干预,经右肋下探查发现并引流了包膜下血肿。此后患者无症状。