Wong C H F, Chau H, Man C W, Chu S K
Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong.
Urol Case Rep. 2019 Oct 15;28:101046. doi: 10.1016/j.eucr.2019.101046. eCollection 2020 Jan.
From the literature, the managements for nephropulmonary fistula were variable. We would like to present our case and review the literature for the best method of care. The common features were 1) infected kidney; 2) ipsilateral lower lobe pneumonia or pleural effusion; 3) sputum and urine culture growing the same organism. Renal gaseous content may not be present on x-ray or even CT scan. The choice of management for the nephropulmonary fistula was diverse. However, conservative managements including antibiotics, endourological procedures for stone clearance, percutaneous drainage were not successful. Nephrectomies were required. Operative tips and anaesthesia preparation recommendations are given.
从文献来看，肾肺瘘的治疗方法各不相同。我们想介绍我们的病例并回顾文献以寻找最佳的治疗方法。常见特征包括：1）感染性肾脏；2）同侧下叶肺炎或胸腔积液；3）痰液和尿液培养出相同的病原体。X线甚至CT扫描可能显示不出肾脏内的气体成分。肾肺瘘的治疗选择多种多样。然而，包括抗生素、内镜下结石清除术、经皮引流等保守治疗均未成功。需要进行肾切除术。文中给出了手术技巧和麻醉准备建议。
