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剖宫产术中输尿管损伤致孤立肾急性处理后2年的功能损害:1例病例报告

Solitary kidney functional damage due to caesarean ureteric injury monitored for 2 years after acute management: A case report.

作者信息

Ali Mahamudu Ayamba, Oyortey Mawuenyo Attawa, Maalman Raymond Saa-Eru, Donkor Yaw Otchere, Adanu Kekeli Kodjo, Kyei Mathew Yamoah

机构信息

Departments of Surgery and Basic Medical Science, School of Medicine, University of Health and Allied Science, Ho, Volta Region, Ghana.

Department of Surgery, University of Ghana Medical School, Accra, Ghana.

出版信息

Case Rep Womens Health. 2022 Aug 10;36:e00439. doi: 10.1016/j.crwh.2022.e00439. eCollection 2022 Oct.

Abstract

Caesarean section with associated ureteric injuries that damage kidney function is uncommon. Such injury in women with a solitary kidney has far-reaching effects if the diagnosis is delayed. The case report describes the successful acute management with stenting of ureteric damage after caesarean section in a woman with a solitary kidney. A 29-year-old woman presented with anuria, hypertension (174/101 mmHg) and flank pain 3 days after caesarean section. Physical examination was significant for peri-orbital oedema, left flank tenderness, pallor and delirium. A diagnosis of acute kidney injury was confirmed by elevated blood urea and creatinine levels. An ultrasound scan revealed a solitary hydronephrotic left kidney. She had successful acute management at a resource-deprived facility, with normal renal function at a 2-year follow-up. Proteinuria lasted for about three months after surgery. Recovery of solitary kidney function with acute kidney injury due to caesarean section ureteric injury may be associated with prolonged proteinuria without evidence of further functional deterioration.

摘要

剖宫产术伴发损害肾功能的输尿管损伤并不常见。对于单肾女性而言,若诊断延误,此类损伤会产生深远影响。该病例报告描述了一名单肾女性剖宫产术后输尿管损伤通过支架置入成功进行急性处理的情况。一名29岁女性在剖宫产术后3天出现无尿、高血压(174/101 mmHg)和胁腹疼痛。体格检查发现眶周水肿、左胁腹压痛、面色苍白和谵妄。血尿素和肌酐水平升高证实了急性肾损伤的诊断。超声扫描显示左肾孤立性肾积水。她在资源匮乏的医疗机构获得了成功的急性处理,在2年随访时肾功能正常。蛋白尿在术后持续了约三个月。因剖宫产输尿管损伤导致急性肾损伤的单肾功能恢复可能与蛋白尿持续时间延长有关,且无进一步功能恶化的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e69/9398914/cede9642c252/gr1.jpg

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