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孤立肾患者肾造瘘管置入术后肾实质内肾动脉假性动脉瘤:一例报告。

Intraparenchymal renal artery pseudoaneurysm following nephrostomy tube insertion in a patient with a solitary kidney: A case report.

作者信息

Artiles-Medina A, Hevia-Palacios M, Laso-García I, Duque-Ruiz G, Arias-Funez F, Burgos-Revilla F J

机构信息

Department of Urology, Hospital Universitario Ramón y Cajal, Spain.

Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Spain.

出版信息

Urol Case Rep. 2020 Oct 28;34:101471. doi: 10.1016/j.eucr.2020.101471. eCollection 2021 Jan.

DOI:10.1016/j.eucr.2020.101471
PMID:33240793
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7674289/
Abstract

Intraparenchymal renal artery aneurysms are uncommon and represent less than 10% of all renal artery aneurysms. They are caused by trauma or iatrogenic injury, and their rupture can lead to life-threatening hemorrhage. We report the case of a 48-year-old male with history of left solitary kidney and orthotopic neobladder, who presented with massive hematuria 7 days after nephrostomy tube placement because of obstructive uropathy and acute renal failure due to ureteroileal stricture. An abdominal CT angiography revealed an intraparenchymal renal artery aneurysm, and it was successfully treated with superselective endovascular embolization, achieving maximal parenchymal preservation.

摘要

肾实质内肾动脉瘤并不常见,占所有肾动脉瘤的比例不到10%。它们由外伤或医源性损伤引起,破裂可导致危及生命的出血。我们报告一例48岁男性病例,该患者有左孤立肾和原位新膀胱病史,因输尿管回肠吻合口狭窄导致梗阻性尿路病和急性肾衰竭,在放置肾造瘘管7天后出现大量血尿。腹部CT血管造影显示肾实质内肾动脉瘤,通过超选择性血管内栓塞成功治疗,最大程度地保留了肾实质。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c0/7674289/23951cc3d815/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c0/7674289/208c95624ac7/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c0/7674289/23951cc3d815/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c0/7674289/208c95624ac7/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c0/7674289/23951cc3d815/gr2.jpg

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本文引用的文献

1
Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors.经皮肾镜取石术后肾出血治疗中初始超选择性肾动脉栓塞失败:危险因素的相关分析
Exp Ther Med. 2019 Nov;18(5):4151-4156. doi: 10.3892/etm.2019.8033. Epub 2019 Sep 20.
2
Endovascular management of iatrogenic renal vascular injuries complicating percutaneous nephrolithotomy: Role of renal angiography and embolization; an analysis of 159 cases.经皮肾镜取石术并发医源性肾血管损伤的血管内治疗:肾血管造影和栓塞的作用;159例分析
Indian J Radiol Imaging. 2017 Jul-Sep;27(3):293-297. doi: 10.4103/ijri.IJRI_54_17.
3
Conservative management of renal artery pseudoaneurysm following partial nephrectomy.
肾部分切除术后肾动脉假性动脉瘤的保守治疗
Ann R Coll Surg Engl. 2014 Mar;96(2):e17-8. doi: 10.1308/003588414X13814021678673.
4
Spontaneous rupture of a renal artery aneurysm presenting as gross hematuria.表现为肉眼血尿的肾动脉动脉瘤自发性破裂。
Rev Urol. 2010 Fall;12(4):e193-6.
5
Renal pseudoaneurysm: an overview.肾假性动脉瘤:概述。
Nat Rev Urol. 2010 Nov;7(11):619-25. doi: 10.1038/nrurol.2010.163. Epub 2010 Oct 12.