Herbst Meghan Kelly, Herbst Timothy
University of Connecticut School of Medicine, Department of Emergency Medicine, Farmington, CT, United States of America.
Jefferson Radiology, East Hartford, CT, United States of America.
Am J Emerg Med. 2022 Jan;51:429.e3-429.e5. doi: 10.1016/j.ajem.2021.07.030. Epub 2021 Jul 22.
Acute flank pain associated with hematuria and unilateral hydronephrosis is a classic presentation for an obstructing ureteral stone. However, in the setting of hemorrhagic cystitis, blood can acutely obstruct the distal ureter and infrequently result in hydronephrosis. We present a case of an adult female patient with hemorrhagic cystitis who presented with acute right flank pain associated with unilateral hydronephrosis and perinephric fluid on point-of-care ultrasound (PoCUS) in the absence of renal or ureteral abnormality on CT scan hours earlier. Her symptoms resolved, urine cultures showed no growth, and her outpatient follow-up was unremarkable. We suspect given the acute onset of right obstructive uropathy, an unremarkable CT just hours earlier, and the brief nature of her symptoms, that blood obstructed her distal UVJ leading to acute and transient obstructive uropathy.
伴有血尿和单侧肾积水的急性胁腹痛是输尿管结石梗阻的典型表现。然而，在出血性膀胱炎的情况下，血液可急性阻塞输尿管远端，偶尔导致肾积水。我们报告一例成年女性出血性膀胱炎患者，其表现为急性右胁腹痛，伴有单侧肾积水，且在数小时前的CT扫描未发现肾脏或输尿管异常的情况下，床旁超声（PoCUS）显示肾周积液。她的症状缓解，尿培养无细菌生长，门诊随访无异常。鉴于急性右阻塞性尿路病的急性发作、数小时前CT检查无异常以及症状的短暂性，我们怀疑是血液阻塞了她的远端输尿管膀胱连接部，导致急性和短暂性阻塞性尿路病。
