Kodama Koichi, Takase Yasukazu, Tokai Ryutaro, Saito Katsuhiko
Department of Urology, Toyama City Hospital, Toyama, Japan.
Department of Pathology, Toyama City Hospital, Toyama, Japan.
Asian J Endosc Surg. 2019 Jul;12(3):341-343. doi: 10.1111/ases.12651. Epub 2018 Sep 21.
Renal arteriovenous fistula (AVF) is a rare but potentially severe and life-threatening entity. It can occur after various invasive renal interventions, including resection of a localized renal tumor, renal biopsy, percutaneous renal surgery, and even blunt injury of the kidney. The time of clinical presentation of a renal AVF is variable and may occur decades after the injury originally occurred. Here, we report a case of renal AVF induced by extracorporeal shock wave lithotripsy 11 years earlier in an asymptomatic 72-year-old woman. Given the patient's pre-existing hemodialysis dependence, retroperitoneoscopic nephrectomy was performed. On the basis of patient's clinical history, the location of the renal AVF, and the pathological diagnosis, we suggested that renal AVF was a late consequence of the injury to the intrarenal vessels induced by extracorporeal shock wave lithotripsy.
肾动静脉瘘（AVF）是一种罕见但可能严重且危及生命的病症。它可发生于各种侵入性肾脏干预操作后，包括局部肾肿瘤切除、肾活检、经皮肾手术，甚至肾脏钝性损伤后。肾AVF的临床表现时间不一，可能在最初受伤数十年后才出现。在此，我们报告一例11年前因体外冲击波碎石术诱发肾AVF的病例，患者为一名72岁无症状女性。鉴于患者既往有血液透析依赖，遂行后腹腔镜肾切除术。根据患者的临床病史、肾AVF的位置及病理诊断，我们认为肾AVF是体外冲击波碎石术导致肾内血管损伤的晚期后果。
