Barns Mitchell Egerton, Hanna Joseph, Kuan Melvyn
Sir Charles Gardiner Hospital, Department of Urology, Perth, Western Australia, Australia.
Urol Case Rep. 2023 Jun 25;50:102464. doi: 10.1016/j.eucr.2023.102464. eCollection 2023 Sep.
Here we present a rare case of life-threatening spontaneous renal haemorrhage following elective vascular surgery. A 73-year-old gentleman presents to the ED with acute onset right sided flank pain, 24 hours post bilateral renal artery stent insertion for renal artery stenosis. Subsequent angiography demonstrated bilateral renal artery stent occlusion with near complete bilateral kidney infarction. The patient urgently underwent bilateral renal artery thrombectomy. Post-operatively the patient developed severe unilateral flank pain and became haemodynamically unstable. Subsequent imaging revealed a large right sided retroperitoneal haematoma with active arterial bleeding. The patient ultimately underwent a right sided trauma nephrectomy for haemorrhage control.
在此，我们报告一例择期血管手术后发生危及生命的自发性肾出血的罕见病例。一名73岁男性在因肾动脉狭窄行双侧肾动脉支架置入术后24小时，因急性右侧胁腹疼痛就诊于急诊科。随后的血管造影显示双侧肾动脉支架闭塞，双侧肾脏几乎完全梗死。患者紧急接受了双侧肾动脉血栓切除术。术后患者出现严重的单侧胁腹疼痛，血流动力学不稳定。随后的影像学检查显示右侧腹膜后有一个大血肿，伴有活动性动脉出血。患者最终接受了右侧创伤性肾切除术以控制出血。
