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。

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

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

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

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

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.

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。