Debbink K P, Tashjian D B, Tirabassi M V, Gaffey R, Nahmias J
Baystate Medical Center, Springfield, MA, United States.
Baystate Children's Hospital, Springfield, MA, United States.
Trauma Case Rep. 2017 Jul 31;10:16-18. doi: 10.1016/j.tcr.2017.07.002. eCollection 2017 Aug.
Ureteric trauma is rare, occurring in < 1% of all traumas. We present a unique case of a 13 year old female who sustained a penetrating abdominal injury from a bicycle handlebar. Upon initial examination there was herniation of bowel through the abdominal wound, so exploratory laparotomy was performed. A serosal injury of the colon and bleeding mesenteric veins were encountered; the retroperitoneum was not explored at that time. Postoperative course was remarkable for a doubling of the serum creatinine, increasing abdominal distention and pain. Computed tomography on postoperative day five demonstrated a large amount of intra-abdominal fluid. The patient was taken for re-exploration. The left ureter was found to be completely transected. It was repaired over a double-J stent. This case demonstrates the need for a high index of suspicion in the diagnosis of ureteric injury.
输尿管损伤很少见，在所有创伤中发生率低于1%。我们报告一例独特病例，一名13岁女性因自行车车把导致腹部贯通伤。初次检查时，肠道通过腹部伤口疝出，因此进行了剖腹探查术。术中发现结肠浆膜损伤和肠系膜静脉出血；当时未探查腹膜后。术后病程表现为血清肌酐翻倍、腹胀和疼痛加剧。术后第5天的计算机断层扫描显示腹腔内有大量液体。患者接受再次探查。发现左输尿管完全横断。通过双J支架进行了修复。该病例表明，在诊断输尿管损伤时需要高度怀疑。
