安全带损伤后腹膜后血肿导致的迟发性肾积水：一例报告
Delayed hydronephrosis due to retroperitoneal hematoma after a seatbelt injury: A case report.
作者信息
Yumoto Tetsuya, Kondo Yoshitaka, Kumon Kento, Masaoka Yoshihisa, Hiraki Takao, Yamada Taihei, Naito Hiromichi, Nakao Atsunori
机构信息
Advanced Emergency and Critical Care Medical Center, Okayama University Hospital Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Department of Radiology, Okayama University Medical School, Okayama, Japan.
出版信息
Medicine (Baltimore). 2018 Jun;97(23):e11022. doi: 10.1097/MD.0000000000011022.
RATIONALE
Hydronephrosis caused by retroperitoneal hematoma after a seatbelt injury is a unique clinical entity.
PATIENT CONCERNS
A 21-year-old man, who had been wearing a seatbelt, was brought to our hospital after a motor vehicle collision, complaining of abdominal pain. Computed tomography (CT) revealed retroperitoneal hematoma in the upper pelvic region. Since he was hemodynamically stable throughout admission, he was managed conservatively. Seventeen days after initial discharge, the patient revisited our emergency department due to right back pain.
DIAGNOSES
CT scans indicated retroperitoneal hematoma growth resulting in hydronephrosis of the right kidney.
INTERVENTIONS
Laparoscopic drainage of the retroperitoneal hematoma was successfully performed.
OUTCOMES
His symptoms resolved after the surgery. Follow-up CT scans three months later demonstrated complete resolution of the hydronephrosis and retroperitoneal hematoma.
LESSONS
Our case highlights a patient with delayed hydronephrosis because of retroperitoneal hematoma expansion after a seatbelt injury.
理论依据
安全带损伤后腹膜后血肿导致的肾积水是一种独特的临床病症。
患者情况
一名21岁男性，系安全带后在机动车碰撞事故后被送至我院，主诉腹痛。计算机断层扫描（CT）显示盆腔上部腹膜后血肿。由于他在整个住院期间血流动力学稳定，因此采取了保守治疗。首次出院17天后，患者因右背部疼痛再次就诊于我院急诊科。
诊断
CT扫描显示腹膜后血肿增大，导致右肾积水。
干预措施
成功进行了腹腔镜下腹膜后血肿引流术。
结果
术后他的症状得到缓解。三个月后的随访CT扫描显示肾积水和腹膜后血肿完全消退。
经验教训
我们的病例突出了一名因安全带损伤后腹膜后血肿扩大而出现延迟性肾积水的患者。
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