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急诊科一名险些跌倒患者的肾动脉夹层。

Renal Artery Dissection in an Emergency Department Patient With a Near Fall.

作者信息

Boulet Susannah, Milliron Melody L

机构信息

Emergency Medicine, Allegheny Health Network-St Vincent Hospital, Erie, USA.

出版信息

Cureus. 2023 Mar 27;15(3):e36759. doi: 10.7759/cureus.36759. eCollection 2023 Mar.

Abstract

51-year-old male presented to the emergency department with left flank pain after a near fall on steps. Computed tomography of the abdomen and pelvis with contrast showed a non-enhancing left kidney, secondary to suspected acute traumatic dissection of the left renal artery. Renal artery dissection is typically affiliated with blunt abdominal trauma, though it can also occur spontaneously. The diagnosis of a renal artery dissection after minor trauma can often go unrecognized due to a lack of initial severe symptoms.Management will vary upon the age of the injury, the preservation of the kidney, and the extent of associated injuries.Ultimately, management should be dictated by discussion with trauma surgery, vascular surgery, urology, or interventional radiology consultants. Knowing the mechanism of injury and patient risk factors can help guide your ability to successfully identify and treat the patient, limiting delays in care and potentially lowering the incidence of organ injury.

摘要

一名51岁男性在楼梯上险些摔倒后,因左侧胁腹疼痛被送往急诊科。腹部和骨盆增强计算机断层扫描显示左肾无强化,怀疑是左肾动脉急性创伤性夹层所致。肾动脉夹层通常与腹部钝性创伤有关,不过也可能自发发生。由于最初缺乏严重症状,轻度创伤后肾动脉夹层的诊断常常未被识别。治疗方法会因损伤时间、肾脏保留情况以及相关损伤的程度而有所不同。最终,应通过与创伤外科、血管外科、泌尿外科或介入放射科会诊医生讨论来决定治疗方案。了解损伤机制和患者风险因素有助于指导你成功识别和治疗患者的能力,减少治疗延误,并可能降低器官损伤的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f23/10132788/ba1e2275c6b7/cureus-0015-00000036759-i01.jpg

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