Cortese Francesco, Fransvea Pietro, Marcello Roberto, Saputelli Alessandra, Lepre Luca, Gioffrè Aldo, Sganga Gabriele
Emergency Surgery and Trauma Care Unit, St. Filippo Neri's Hospital, Rome, Italy.
Faculty of Medicine and Psychology, "Sapienza" University of Rome, St. Andrea's Hospital, Italy.
Int J Surg Case Rep. 2017;41:158-161. doi: 10.1016/j.ijscr.2017.08.070. Epub 2017 Oct 10.
Renal injuries occur in 10% of blunt abdominal traumas, 7% of these occur in kidneys with congenital or acquired disorders. Trauma of horseshoe kidney is an uncommon finding.
We present the case of 31 year-old caucasian man with no remarkable personal records, who was brought to our Trauma Unit soon after being involved in a motorcycle collision. A Contrast Enhanced - Multi Detector Computed Tomography (ce-MDCT) revealed a double disconnection of a horseshoe kidney. The patient was not aware of bearing such abnormality.
Trauma of horseshoe kidney is an uncommon finding. The abdominal ce-MDCT scan is the diagnostic tool of choice since the renal anatomy, injury grading and vascular or urinary tract abnormalities are well depicted and easily identified. The conservative management of these injuries is associated with a lower rate of nephrectomies and kidney failure while selective trans-catheter renal embolization is a challenging treatment option. However surgery can be a treatment of choice and should be aimed to preserve renal function.
the interest in our case lies in the rarity and particular anatomical aspect of such injuries and the implication related to its management in an emergency setting.
肾损伤发生于10%的钝性腹部创伤中，其中7%发生于患有先天性或后天性疾病的肾脏。马蹄肾创伤是一种罕见的发现。
我们报告一例31岁无显著个人病史的白种男性病例，该患者在摩托车碰撞事故后不久被送至我院创伤科。对比增强多层螺旋计算机断层扫描（ce-MDCT）显示马蹄肾双离断。患者此前未意识到自己有此异常。
马蹄肾创伤是一种罕见的发现。腹部ce-MDCT扫描是首选的诊断工具，因为其能很好地显示肾脏解剖结构、损伤分级以及血管或尿路异常，且易于识别。这些损伤的保守治疗与较低的肾切除率和肾衰竭发生率相关，而选择性经导管肾动脉栓塞是一种具有挑战性的治疗选择。然而，手术可能是一种治疗选择，且应以保留肾功能为目标。
我们这个病例的意义在于此类损伤的罕见性和特殊解剖结构，以及在紧急情况下其处理方式的影响。
