Asai Yu, Iwakura Takamasa, Ishigaki Sayaka, Isobe Shinsuke, Fujikura Tomoyuki, Ohashi Naro, Kato Akihiko, Yasuda Hideo
First Department of Medicine, Division of Nephrology, Hamamatsu University School of Medicine, Japan.
Blood Purification Unit, Hamamatsu University School of Medicine, Japan.
Intern Med. 2025 Mar 15;64(6):881-885. doi: 10.2169/internalmedicine.3888-24. Epub 2024 Aug 8.
A percutaneous renal biopsy (PRB) is a standard procedure for diagnosing renal disease, but can cause bleeding complications. Bleeding after a PRB can be classified as early- or late-onset, depending on the timing of the onset of the bleeding symptoms (<24 h or ≥24 h). We herein report two patients who experienced bleeding complications: one experienced early-onset bleeding from the 12th subcostal artery, and the other experienced late-onset bleeding from an arteriovenous fistula between a branch of the renal artery and renal vein. In both cases, the origin of the bleeding vessel was misjudged during the first examination. We discuss the diagnostic pitfalls of the origin of bleeding after a PRB and propose measures to avoid falling such pitfalls.
经皮肾活检(PRB)是诊断肾脏疾病的标准程序,但可能导致出血并发症。PRB后的出血可根据出血症状出现的时间(<24小时或≥24小时)分为早发性或迟发性。我们在此报告两名发生出血并发症的患者:一名患者从第12肋下动脉出现早发性出血,另一名患者从肾动脉分支与肾静脉之间的动静脉瘘出现迟发性出血。在这两例病例中,首次检查时均误判了出血血管的来源。我们讨论了PRB后出血来源的诊断陷阱,并提出避免陷入此类陷阱的措施。