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尿潴留继发深静脉血栓形成和肺栓塞:1例报告

Deep vein thrombosis and pulmonary embolism secondary to urinary retention: a case report.

作者信息

Kawada Tatsushi, Yoshioka Takashi, Araki Motoo, Nose Hiroyuki, Oeda Tadashi

机构信息

Department of Urology, Onomichi Municipal Hospital, 3-1170-177, Shin-Takayama, Onomichi-shi, Hiroshima, 722-8503, Japan.

Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima, 960-1295, Japan.

出版信息

J Med Case Rep. 2018 Mar 23;12(1):78. doi: 10.1186/s13256-018-1605-3.

Abstract

BACKGROUND

Pulmonary embolism occurs when a blood thrombus forms and travels from a vein in the body to an artery in the lung. Thrombi often develop in one of the deep veins of the legs, thighs, or pelvis, a condition known as deep vein thrombosis. In this report, we describe a rare instance of a patient who developed deep vein thrombosis and pulmonary embolism secondary to urinary retention, and we also review some of the literature.

CASE PRESENTATION

A 75-year-old Japanese man visited our hospital with the complaint of lower extremity weakness. A physical examination revealed bilateral leg edema. Contrast-enhanced computed tomography showed thrombi in both the bilateral intrapelvic veins and the right pulmonary artery, with an extremely distended bladder. We diagnosed deep vein thrombosis and pulmonary embolism due to urinary retention, which was attributed to detrusor insufficiency owing to both taking an anticholinergic drug and neurogenic bladder. The patient was immediately started on both management of voiding dysfunction and anticoagulant therapy.

CONCLUSIONS

We encountered a patient with deep vein thrombosis and pulmonary embolism secondary to urinary retention that could have been fatal. In such cases, clinicians should always take into account appropriate management of voiding dysfunction.

摘要

背景

当血栓形成并从身体的静脉转移至肺部的动脉时,就会发生肺栓塞。血栓通常在腿部、大腿或骨盆的深静脉中形成,这种情况称为深静脉血栓形成。在本报告中,我们描述了一例罕见的因尿潴留继发深静脉血栓形成和肺栓塞的患者病例,并对部分文献进行了综述。

病例介绍

一名75岁的日本男性因下肢无力前来我院就诊。体格检查发现双侧腿部水肿。增强计算机断层扫描显示双侧盆腔内静脉和右肺动脉均有血栓形成,且膀胱极度膨胀。我们诊断为因尿潴留导致的深静脉血栓形成和肺栓塞,其原因是服用抗胆碱能药物和神经源性膀胱导致逼尿肌功能不全。患者立即开始接受排尿功能障碍管理和抗凝治疗。

结论

我们遇到了一例因尿潴留继发深静脉血栓形成和肺栓塞的患者,这种情况可能是致命的。在这类病例中,临床医生应始终考虑对排尿功能障碍进行适当的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/325e/5865341/64ee50e3f845/13256_2018_1605_Fig1_HTML.jpg

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