Regmi Pradeep, Shrestha Suraj, Poddar Elisha, Sharma Deewakar
Department of Radiology, Tribhuvan University Teaching Hospital.
Maharajgunj Medical Campus, Institute of Medicine.
Ann Med Surg (Lond). 2023 Feb 7;85(2):225-227. doi: 10.1097/MS9.0000000000000196. eCollection 2023 Feb.
Page kidney results from external compression of the kidney by a subcapsular hematoma and is one of the rare but treatable causes of secondary hypertension. The majority are traumatic or iatrogenic and often unilateral. Spontaneous bilateral Page kidney is rare.
A 35-year P1 with gestational hypertension presented with a persistent postpartum elevation of blood pressure (BP). Imaging studies revealed bilateral renal subcapsular hematoma (left>right). She was managed with an angiotensin receptor blocker initially and ultrasound-guided percutaneous drainage of the collection for the optimal control of elevated BP.
Ultrasonography and computed tomography of the kidneys are the most frequently used for diagnosing a Page kidney. Medical management with antihypertensive and regular follow-ups form the first line of treatment in Page kidneys. Percutaneous drainage, surgical decortication, laparoscopic intervention, and nephrectomy are necessary in cases of organized late hematomas.
Spontaneous bilateral Page kidney is a rare but potentially treatable and curable form of hypertension. Percutaneous drainage is an effective method to drain the hematoma and control elevated BP.
“页状肾”是由肾包膜下血肿对肾脏的外部压迫所致，是继发性高血压中罕见但可治疗的病因之一。大多数病例是创伤性或医源性的，且常为单侧。自发性双侧“页状肾”罕见。
一名35岁、孕1产0且患有妊娠期高血压的女性产后血压持续升高。影像学检查显示双侧肾包膜下血肿（左侧>右侧）。最初使用血管紧张素受体阻滞剂进行治疗，并通过超声引导下经皮穿刺引流血肿以最佳控制血压升高。
肾脏超声检查和计算机断层扫描是诊断“页状肾”最常用的方法。使用抗高血压药物进行药物治疗并定期随访是“页状肾”的一线治疗方法。对于有组织的晚期血肿病例，经皮引流、手术去皮质、腹腔镜干预和肾切除术是必要的。
自发性双侧“页状肾”是一种罕见但潜在可治疗且可治愈的高血压形式。经皮引流是引流血肿和控制血压升高的有效方法。
