School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
Transplant Surgery, University of Rochester Medical Center, Rochester, New York, USA.
BMJ Case Rep. 2022 Sep 26;15(9):e249625. doi: 10.1136/bcr-2022-249625.
A male in his late 70s with a history of an uncomplicated kidney transplantation 20 years prior was brought to the Emergency Department after experiencing blunt abdominal trauma following a motor vehicle collision. Imaging revealed a large perinephric haematoma, a retroperitoneal haematoma and multiple fractures. He was admitted to the intensive care unit where a renal haematoma was found to be expanding with ultrasonography (US) and developed renal dysfunction including anuria and hyperkalemia. His creatinine rose to twice his baseline and Doppler US showed elevated resistive indices, confirming extrinsic compression and causing a Page phenomenon. An open surgical exploration through the upper aspect of his Gibson incisional scar was performed followed by evacuation of the haematoma. An intraoperative US was done demonstrating good flow in the renal vessels. His postoperative course was uncomplicated and was discharged home with renal function back to baseline. On follow-up, he continued to have a good renal function.
一位 70 多岁的男性，20 年前曾接受过一次无并发症的肾脏移植手术，因机动车碰撞后遭受钝性腹部外伤，被送往急诊科。影像学检查显示存在巨大的肾周血肿、腹膜后血肿和多处骨折。他被收入重症监护病房，超声检查（US）发现肾血肿不断扩大，并出现肾功能障碍，包括无尿和高钾血症。他的肌酐升高到基线水平的两倍，多普勒 US 显示阻力指数升高，证实存在外在压迫，导致 Page 现象。通过他 Gibson 切口瘢痕的上方进行了开放式外科探查，并清除了血肿。术中进行了 US 检查，显示肾血管血流良好。他的术后恢复过程顺利，出院时肾功能恢复到基线水平。随访时，他的肾功能持续良好。
