Takigawa H, Kagawa S, Aga Y, Uema K, Sumiyoshi Y, Inai T, Tamura M
Department of Urology, School of Medicine, University of Tokushima.
Hinyokika Kiyo. 1988 Sep;34(9):1631-4.
A case of segmental renal arterial thrombosis occurring after bilateral surgical stripping and interruption of renal pedicle lymphatics for chyluria is presented. This case showed elevation of serum creatinine (6.6 mg/dl) and lactate dehydrogenase (1131 IU/L) on the 4th day after operation, and on the 14th day, renal scintigraphy with 99 m-Tc diethylenetriamine penta acid acetic showed bilateral marked decrease of glomerular filtration rate. Aortography and selective left renal angiography demonstrated left segmental renal thrombosis, but right renal arteries were intact on the 20th day after operation. Systemic anticoagulation therapy was performed, but left renal function was destroyed completely. Excessive and prolonged retraction of the renal artery with vascular tape may have resulted in this unfortunate complication.
本文报告1例因乳糜尿行双侧肾蒂淋巴管手术剥离及阻断后发生节段性肾动脉血栓形成的病例。该病例术后第4天血清肌酐(6.6mg/dl)和乳酸脱氢酶(1131IU/L)升高,术后第14天,99m锝二乙三胺五醋酸肾闪烁显像显示双侧肾小球滤过率明显降低。主动脉造影和选择性左肾血管造影显示左肾节段性血栓形成,但术后第20天右肾动脉完好。虽进行了全身抗凝治疗,但左肾功能仍完全受损。用血管带过度、长时间牵拉肾动脉可能导致了这一不幸的并发症。