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凝血因子 VII 缺乏导致的自发性肾破裂:一例报告。

Spontaneous renal rupture caused by factor VII deficiency: A case report.

作者信息

Yang Chao, Luo Mingjun, Li Langlang, Yang Qizhi

机构信息

Department of Urology, 302 Hospital of China Guizhou Aviation Industry Group, Anshun, Guizhou, China.

出版信息

Medicine (Baltimore). 2024 May 3;103(18):e36130. doi: 10.1097/MD.0000000000036130.

Abstract

RATIONALE

Spontaneous renal rupture is an uncommon disease, it usually occurs after upper urinary calculi-related operation treatment or renal tumor. This disease caused by factor VII deficiency has rarely reported.

PATIENT CONCERNS

A 49-year-old woman came to our hospital with on the left flank pain and gross hematuria that had persisted for 10 days. The patient had no recent history of waist and abdominal trauma or surgical history recently.

DIAGNOSES

An outside computed tomography (CT) examination revealed left renal rupture before arriving at our hospital, but she was not treated. Further laboratory examination revealed that the patient condition was turned out to be hemophilia caused by factor VII deficiency.

INTERVENTION

We have used both internal and external drainage methods, and supplemented with coagulation factor.

OUTCOME

After 9 months of follow-up, it was observed that the left renal hematoma and urinary extravasation was completely absorbed.

LESSONS

Spontaneous renal rupture for hemophilia is a clinical emergency. When spontaneous renal rupture is associated with abnormal coagulation function, and the coagulation function cannot be corrected by conventional treatment, the possibility of hemophilia needs to be considered, and the type of hemophilia needs to be further defined. This case indicates a successful resolution of spontaneous renal rupture, it can provide guiding value for our clinical practice.

摘要

理论依据

自发性肾破裂是一种罕见疾病,通常发生在上尿路结石相关手术治疗后或肾肿瘤后。由因子VII缺乏引起的这种疾病鲜有报道。

患者情况

一名49岁女性因左侧腰痛和肉眼血尿持续10天前来我院就诊。患者近期无腰腹部外伤史或手术史。

诊断

在来我院之前,外院的计算机断层扫描(CT)检查显示左侧肾破裂,但未进行治疗。进一步实验室检查发现患者病情原来是由因子VII缺乏引起的血友病。

干预措施

我们采用了内外引流方法,并补充了凝血因子。

结果

经过9个月的随访,观察到左侧肾血肿和尿外渗完全吸收。

经验教训

血友病导致的自发性肾破裂是一种临床急症。当自发性肾破裂伴有凝血功能异常,且常规治疗无法纠正凝血功能时,需要考虑血友病的可能性,并进一步明确血友病的类型。本病例表明自发性肾破裂得到成功解决,可为我们的临床实践提供指导价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63af/11062645/0d96b8c91d12/medi-103-e36130-g001.jpg

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