自发性肾出血
SPONTANEOUS RENAL HAEMORRHAGE.
作者信息
Cavaco João Luís, Capinha Francisco, Pires Maria José, Furão Rodrigues Ana, Oliveira Pedro Ana, Pais de Lacerda António
机构信息
Department of Internal Medicine II, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal.
Department of Gastroenterology, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Lisbon, Portugal.
出版信息
Eur J Case Rep Intern Med. 2023 Feb 10;10(2):003749. doi: 10.12890/2023_003749. eCollection 2023.
INTRODUCTION
Spontaneous renal haemorrhage is a rare condition with potentially serious complications.
CASE DESCRIPTION
We describe a 76-year-old woman with a 3-day history of fever and malaise, with no associated trauma. She was admitted to our emergency room with signs of shock. A contrast-enhanced computed tomography scan revealed an extensive right kidney haematoma. Despite fast surgical management, the patient died less than 24 h after admission.
CONCLUSION
Spontaneous renal haemorrhage should be quickly identified due to its fatal complications. Early diagnosis leads to a better prognosis.
LEARNING POINTS
Spontaneous renal haemorrhage is a severe and rare condition in the absence of trauma and antithrombotic therapy.Contrast-enhanced abdominal CT scan is the gold standard for diagnosis.Surgical nephrectomy should be considered in haemodynamically unstable patients.Conservative therapy with intravenous resuscitation and blood products should be considered in stable patients.
引言
自发性肾出血是一种罕见疾病，可能伴有严重并发症。
病例描述
我们描述一名76岁女性，有3天发热和不适病史，无相关外伤史。她因休克体征被收入我们的急诊室。增强计算机断层扫描显示右肾广泛血肿。尽管进行了快速手术治疗，但患者在入院后不到24小时死亡。
结论
由于自发性肾出血的致命并发症，应迅速识别。早期诊断可带来更好的预后。
学习要点
在无外伤和抗血栓治疗的情况下，自发性肾出血是一种严重且罕见的疾病。增强腹部CT扫描是诊断的金标准。血流动力学不稳定的患者应考虑手术肾切除术。稳定的患者应考虑静脉复苏和血液制品的保守治疗。
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