Mitsogiannis Iraklis C, Kostakopoulos Nikolaos A, Lazarou Lazaros, Deliveliotis Konstantinos, Karagiotis Theodoros, Deliveliotis Charalampos
2nd Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, Greece.
J Endourol Case Rep. 2020 Mar 11;6(1):26-29. doi: 10.1089/cren.2019.0103. eCollection 2020.
Renal hematomas, although relatively rare, are potentially life-threatening complications after ureterolithotripsy. We present four cases of renal hematomas that occurred in our department during the past decade (2008-2018). Unstable vital signs, increased inflammatory markers, fever, and flank pain were the commonest postoperative findings. Two patients were treated conservatively and had an uneventful recovery, whereas one patient underwent selective arterial embolization for bleeding control. The fourth patient was diagnosed with contralateral ureteral urothelial tumor and ultimately underwent contralateral radical nephroureterectomy. Application of safety measures during ureteroscopy may reduce the incidence of perirenal hematomas. Prompt diagnosis is based on a thorough clinical examination in combination with imaging to evaluate the location and extent of the hematoma.
肾血肿虽然相对少见，但却是输尿管碎石术后潜在的危及生命的并发症。我们报告了过去十年间（2008 - 2018年）在我们科室发生的4例肾血肿病例。生命体征不稳定、炎症指标升高、发热和胁腹痛是最常见的术后表现。2例患者接受了保守治疗，恢复顺利，而1例患者因出血进行了选择性动脉栓塞术。第4例患者被诊断为对侧输尿管尿路上皮肿瘤，最终接受了对侧根治性肾输尿管切除术。输尿管镜检查期间采取安全措施可能会降低肾周血肿的发生率。及时诊断基于全面的临床检查并结合影像学检查以评估血肿的位置和范围。
