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术后尿漏和腹腔内脓肿的保守治疗

Conservative Management of Postoperative Urinary Leak and Intra-Abdominal Abscess.

作者信息

Herson Andrew B, Villacreses Camila A, Rehm Gina M, Briceno Sean A, Healey Kevin D, Brown Matthew R, Miller Brooke T, Fountain Michael W

机构信息

Urology, Lake Erie College of Osteopathic Medicine, Jacksonville, USA.

Urology, Lake Erie College of Osteopathic Medicine, Fort Myers, USA.

出版信息

Cureus. 2023 Jun 6;15(6):e40039. doi: 10.7759/cureus.40039. eCollection 2023 Jun.

Abstract

Ureteral injury is a rare occurrence in medical practice. Most cases encountered stem from blunt trauma or are iatrogenic, occurring during open abdominal or pelvic surgery and laparoscopic procedures. Prompt diagnosis of ureteral injury allows clinicians to avoid complications including ureteral strictures, abscess, renal failure, sepsis, and loss of the ipsilateral kidney. Treatment depends on whether the ureteral injury was discovered intraoperatively or if it was a delayed diagnosis. Several procedures can be used, including ureteroureterostomy, ureteroileal interposition, and nephrectomy. Stenting can also be a viable option as it can reestablish urinary drainage. Herein, we present the case of a 43-year-old male who presented with complaints of progressive abdominal pain that was subsequently diagnosed as a left ureteral injury and how the use of a ureteral stent allowed him to have a full recovery with optimized normal ureteral function.

摘要

输尿管损伤在医疗实践中较为罕见。大多数病例源于钝性创伤或医源性损伤,发生于开腹或盆腔手术以及腹腔镜手术过程中。输尿管损伤的及时诊断可使临床医生避免包括输尿管狭窄、脓肿、肾衰竭、脓毒症以及同侧肾丧失等并发症。治疗取决于输尿管损伤是在术中发现还是延迟诊断。可采用多种手术方法,包括输尿管输尿管吻合术、输尿管回肠间置术和肾切除术。置入支架也是一种可行的选择,因为它可以重建尿液引流。在此,我们报告一例43岁男性病例,该患者因进行性腹痛就诊,随后被诊断为左侧输尿管损伤,以及输尿管支架的使用如何使他实现完全康复并使输尿管功能恢复正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a1b/10324524/c7f483d89843/cureus-0015-00000040039-i01.jpg

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