Sugimoto Takashi, Ono Yuko, Ueshima Eisuke, Matsushiro Keigo, Yamada Isamu, Kotani Joji
Department of Disaster and Emergency Medicine, Graduate School of Medicine Kobe University Kobe Japan.
Department of Diagnostic and Interventional Radiology Kobe University Kobe Japan.
Acute Med Surg. 2023 Feb 2;10(1):e816. doi: 10.1002/ams2.816. eCollection 2023 Jan-Dec.
The kidneys are one of the organs most commonly affected by blunt trauma; however, the anatomical variations that predispose kidney injury are poorly understood.
An 80-year-old Japanese woman with lumber scoliosis was brought to our hospital because of severe flank pain after a minor fall at home. Contrast-enhanced computed tomography showed a severe left kidney laceration at the level of an acute angle in the vertebral column caused by scoliosis. Extravasation of contrast medium from the left renal artery branches was also noted. Selective arterial embolization achieved hemostasis. The patient was transferred to a rehabilitation facility without sequelae.
Patients with scoliosis could be at higher risk of severe kidney laceration because of intrusion of the vertebral column into the retroperitoneal space. Therefore, even after low-impact trauma, active exploration for kidney injury could be warranted in patients with spinal curvature disorders.
肾脏是最常受钝性创伤影响的器官之一；然而，导致肾损伤的解剖变异却鲜为人知。
一名80岁患有腰椎侧弯的日本女性因在家中轻微跌倒后出现严重侧腹痛被送至我院。增强计算机断层扫描显示，脊柱侧弯导致脊柱锐角水平处左侧肾脏严重撕裂伤。还发现有造影剂从左肾动脉分支外渗。选择性动脉栓塞实现了止血。患者被转至康复机构，未留下后遗症。
由于脊柱侵入腹膜后间隙，脊柱侧弯患者可能有更高的严重肾撕裂伤风险。因此，即使是低冲击力创伤后，对于有脊柱弯曲疾病的患者，也有必要积极探查是否存在肾损伤。
