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剖宫产术后即刻发生肾血管平滑肌脂肪瘤破裂。

Renal angiomyolipoma rupture in the immediate postoperative period following caesarean section.

机构信息

Department of Obstetrics and Gynecology №2, Astana Medical University, Astana, Kazakhstan.

Department of Obstetrics and Gynecology №2, Astana Medical University, Astana, Kazakhstan

出版信息

BMJ Case Rep. 2024 Aug 12;17(8):e261038. doi: 10.1136/bcr-2024-261038.

Abstract

Renal angiomyolipoma (rAML) is a rare benign tumour primarily affecting women due to hormonal influences, with accelerated growth observed during pregnancy. This case report presents a multigravida woman in her mid-20s at 37 weeks of gestation with stable vital signs and normal physical examination findings, except for swelling in the lower extremities. Following caesarean section delivery, she developed flank pain and haematuria in the immediate postoperative period. Emergency surgery revealed a ruptured rAML, resulting in unstable haemodynamics and significant blood loss. A multidisciplinary team performed a left radical nephrectomy to control bleeding. The patient required transfusions, ventilation and postoperative antibiotic therapy. This case underscores the importance of considering rAML rupture in the immediate postoperative period following caesarean section, highlighting the need for prompt evaluation in pregnant women with a history of urologic disorders.

摘要

肾血管平滑肌脂肪瘤(rAML)是一种罕见的良性肿瘤,主要由于激素影响而影响女性,在妊娠期间观察到生长加速。本病例报告介绍了一位 20 多岁的多产妇,在妊娠 37 周时生命体征稳定,体格检查正常,除下肢肿胀外。行剖宫产术后,她在术后即刻出现腰痛和血尿。急诊手术显示 rAML 破裂,导致血流动力学不稳定和大量失血。多学科团队行左根治性肾切除术以控制出血。患者需要输血、通气和术后抗生素治疗。本病例强调了在剖宫产术后即刻考虑 rAML 破裂的重要性,提示对于有泌尿系统疾病病史的孕妇需要及时评估。

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