Sugianto Ronald, Tirtayasa Pande Made Wisnu, Samuel Alwyn Geraldine, Astriani Maria Yoanita, Panuntun Mahendro Aji
Faculty of Medicine, Universitas Udayana, Bali, Indonesia.
Department of Urology, Faculty of Medicine, Universitas Udayana, Bali, Indonesia.
Int J Surg Case Rep. 2022 Sep;98:107614. doi: 10.1016/j.ijscr.2022.107614. Epub 2022 Sep 7.
Spontaneous renal cyst rupture is a rare disease process. Renal masses are heterogeneous tumors that can be benign masses to cancers. This case report aims to provide a brief overview of the renal cyst, clinical symptoms, and management considerations for similar cases.
A previously healthy 30-year-old complained of left back pain a few days ago. There were no abnormalities in the physical and laboratory examination, so CT Scan Abdomen with contrast was performed. It was found that there was a 7.4 cm × 7.0 cm × 7.0 cm cyst. The patients undergo conservative management. Three months later, the patient suddenly fell with severe left back pain. Due to suspicion of spontaneous rupture of the renal cyst, the patient underwent exploration and bleeding control.
The advice to wear an abdominal corset is mandatory to protect against the renal cyst. Atraumatic renal hemorrhage has been associated with a classic Lenk's triad (hypovolemic shock, flank mass, and severe flank pain). The definitive management of renal cyst rupture is initiated by resuscitation, followed by an angiographic embolization or surgical management.
The conservative management should be accompanied by advice to use an abdominal corset to protect the left flank from unintentional pressure.
自发性肾囊肿破裂是一种罕见的疾病过程。肾脏肿块是异质性肿瘤,从良性肿块到癌症都有可能。本病例报告旨在简要概述肾囊肿、临床症状以及类似病例的处理要点。
一名此前健康的30岁患者几天前主诉左背部疼痛。体格检查和实验室检查均无异常,因此进行了腹部增强CT扫描。发现有一个7.4厘米×7.0厘米×7.0厘米的囊肿。患者接受了保守治疗。三个月后,患者突然摔倒,伴有严重的左背部疼痛。由于怀疑肾囊肿自发性破裂,患者接受了探查和出血控制。
建议必须佩戴腹带以保护肾囊肿。非创伤性肾出血与典型的Lenk三联征(低血容量性休克、侧腹肿块和严重的侧腹疼痛)有关。肾囊肿破裂的确定性治疗首先是复苏,随后是血管造影栓塞或手术治疗。
保守治疗应同时建议使用腹带,以保护左侧腹部免受意外压力。