Devos Brecht, Vandeursen Hendrik, d'Archambeau Olivier, Vergauwe Eric
Department of Urology, GZA Hospitals Antwerp, Wilrijk, Belgium.
Department of Interventional Radiology, GZA Hospitals Antwerp, Wilrijk, Belgium.
Case Rep Urol. 2023 Jul 25;2023:5103854. doi: 10.1155/2023/5103854. eCollection 2023.
Pseudoaneurysm (PA) with associated arteriovenous fistula (AVF) is a rare delayed bleeding complication, occurring in less than 1% of patients after percutaneous nephrolithotomy (PNL). . A 54-year-old man underwent PNL on February 28, 2023, for a large renal calculus in the right kidney lower pole, with postoperative delayed bleeding: macroscopic hematuria and bladder clot retention after 3 weeks. An iatrogenic PA and AVF were diagnosed after the failure of conservative measures. The patient was successfully treated with superselective angioembolization (SAE) under local anesthesia.
Late hemorrhagic complications after PNL can be severe. Rapid identification of a renal PA and AVF with SAE has a high success rate and low complication rate, avoiding prolonged hospitalization time and major renal surgery for this patient.
伴有动静脉瘘（AVF）的假性动脉瘤（PA）是一种罕见的延迟性出血并发症，在经皮肾镜取石术（PNL）后不到1%的患者中发生。一名54岁男性于2023年2月28日因右肾下极的巨大肾结石接受了PNL，术后出现延迟性出血：3周后出现肉眼血尿和膀胱血块潴留。保守治疗失败后诊断为医源性PA和AVF。该患者在局部麻醉下成功接受了超选择性血管栓塞术（SAE）治疗。
PNL后的晚期出血并发症可能很严重。通过SAE快速识别肾PA和AVF成功率高、并发症率低，避免了该患者的长期住院时间和大型肾脏手术。
