Yin Guicao, Pan Xiang, Tian Haoyu, Zhou Zhengxi, Li Junhui, Tian Feng, Fan Qibing, Wang Xiaoxiang, Qi Lezhong, Li Yifan
Department of Urology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu 225000, P.R. China.
Exp Ther Med. 2022 Jul 26;24(3):588. doi: 10.3892/etm.2022.11525. eCollection 2022 Sep.
Spontaneous renal parenchymal rupture is a rare clinical emergency. The formation of benign and malignant tumors is the most common underlying cause of spontaneous rupture of renal parenchyma. To the best of our knowledge, 15 cases of renal parenchymal rupture have been reported to date. This report describes a rare case of renal parenchyma rupture in the lower left kidney caused by kidney calculi. Furthermore, previously published cases and articles were reviewed. The patient underwent four extracorporeal shockwave lithotripsy procedures within 2 years. The renal parenchyma rupture caused by the stones was successfully treated by removing the stones and repairing the kidney. However, a large hematoma was discovered around the lower pole of the left kidney, suggesting the possibility of a renal tumor. Therefore, radical nephrectomy was performed. Postoperative pathology revealed the lesion to be consistent with an intrarenal stone, where no malignancy, infection or vascular disease was observed. The present case highlights the requirement to also take into account the patient's clinical history in cases where imaging cannot completely identify the underlying cause of renal parenchymal rupture. Accurate identification of the underlying etiology of spontaneous renal rupture may determine the best treatment for the patient. The purpose of the present report is to facilitate the identification of the disease and reduce the rate of clinical misdiagnosis.
自发性肾实质破裂是一种罕见的临床急症。良性和恶性肿瘤的形成是肾实质自发性破裂最常见的潜在原因。据我们所知，迄今为止已报道了15例肾实质破裂病例。本报告描述了一例罕见的由肾结石引起的左肾下极肾实质破裂病例。此外，还对先前发表的病例和文章进行了回顾。该患者在2年内接受了4次体外冲击波碎石术。通过取出结石和修复肾脏，成功治疗了由结石引起的肾实质破裂。然而，在左肾下极周围发现了一个大血肿，提示可能存在肾肿瘤。因此，进行了根治性肾切除术。术后病理显示病变与肾内结石一致，未观察到恶性肿瘤、感染或血管疾病。本病例强调，在影像学不能完全确定肾实质破裂潜在原因的情况下，还需要考虑患者的临床病史。准确识别自发性肾破裂的潜在病因可能决定患者的最佳治疗方案。本报告的目的是促进对该疾病的识别并降低临床误诊率。
