Shinoda I, Takeuchi T, Oguchi K, Yamaha M, Kobayashi K, Chang P K, Ehara H, Kuriyama M, Kanematsu M, Ban Y
Department of Urology, Gifu University School of Medicine.
Hinyokika Kiyo. 1988 Apr;34(4):665-8.
A case in which the renal segmental artery was injured due to percutaneous nephroureterolithotomy (PNL) and treated by superselective transcatheter embolization is reported. The patient was a 30-year-old man with left ureteral and bilateral renal calculi. The left renal and ureteral calculi were successfully removed by PNL and a 24Fr. nephrostomy catheter was placed for 8 days after PNL. A few minutes after removal of the nephrostomy catheter, arterial bleeding, which seemed to occur due to injury of renal segmental artery associated with PNL, began. The bleeding was stopped by replacement of a 24Fr. nephrostomy catheter and the patient received 5 units of packed red blood cells. Six days after hemorrhage, superselective transcatheter embolization was performed. No further bleeding occurred and the nephrostomy catheter was removed 2 days later without any incident. This interventional technique is safe and useful to control bleeding from renal segmental artery injured by PNL.
报道了1例经皮肾镜输尿管取石术(PNL)导致肾段动脉损伤并通过超选择性经导管栓塞治疗的病例。患者为一名30岁男性,患有左侧输尿管及双侧肾结石。左侧肾及输尿管结石通过PNL成功取出,术后放置一根24Fr.肾造瘘管8天。拔除肾造瘘管几分钟后,出现了似乎因PNL相关的肾段动脉损伤引起的动脉出血。通过重新置入一根24Fr.肾造瘘管止血,患者输注了5单位浓缩红细胞。出血6天后,进行了超选择性经导管栓塞术。未再发生出血,2天后拔除肾造瘘管,未出现任何意外情况。这种介入技术对于控制PNL所致肾段动脉出血是安全且有效的。