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妊娠中肾血管平滑肌脂肪瘤自发性破裂,酷似早产。

Spontaneous rupture of renal angiomyolipoma in pregnancy mimicking preterm labour.

机构信息

Obstetrics and Gynaecology Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia

Obstetrics and Gynaecology Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.

出版信息

BMJ Case Rep. 2024 Feb 6;17(2):e258979. doi: 10.1136/bcr-2023-258979.

Abstract

Ruptured renal angiomyolipoma in pregnancy is uncommon. Pregnant women may present with nonspecific symptoms such as flank or abdominal pain, contraction pain and haematuria. A thorough assessment is needed to reach the correct diagnosis. Management varies between conservative measures, radiological intervention or surgery depending on the patient's haemodynamic status and foetal condition. We present a case of a woman in her 30s, gravida 5 para 3+1 at 28 weeks of gestation, who presented with pain. The pain worsened, and she went into hypovolaemic shock. An exploratory laparotomy and emergency caesarean section were done. Retroperitoneal haematoma was found intraoperatively, but the source of bleeding was difficult to determine. An abdominal CT angiogram subsequently revealed an ongoing bleeding from a ruptured angiomyolipoma. An emergency nephrectomy was performed, and the bleeding was secured.

摘要

妊娠合并肾血管平滑肌脂肪瘤破裂并不常见。孕妇可能表现为非特异性症状,如侧腹痛或腹痛、宫缩痛和血尿。需要进行全面评估以明确诊断。根据患者的血流动力学状态和胎儿情况,治疗方法在保守治疗、放射介入或手术之间有所不同。我们报告了 1 例 30 多岁的 5 产 3+1 孕 28 周的孕妇,因腹痛就诊。腹痛加重,并出现低血容量性休克。行剖腹探查术和急诊剖宫产术。术中发现腹膜后血肿,但难以确定出血来源。随后行腹部 CT 血管造影显示破裂的血管平滑肌脂肪瘤持续出血。行紧急肾切除术,出血得到控制。

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[Renal angiomyolipoma rupture during pregnancy].[妊娠期肾血管平滑肌脂肪瘤破裂]
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本文引用的文献

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Spontaneous Retroperitoneal Hemorrhage.自发性腹膜后出血
J Emerg Med. 2019 Jun;56(6):713-714. doi: 10.1016/j.jemermed.2019.01.037. Epub 2019 Mar 14.
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Conservative management of a retroperitoneal hemorrhage following a ruptured renal angiomyolipoma in pregnancy.
J Obstet Gynaecol Res. 2011 Feb;37(2):156-9. doi: 10.1111/j.1447-0756.2010.01326.x. Epub 2010 Dec 16.

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