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双侧多囊肾合并重度肾外伤的治疗:一例报告

Management of high-grade kidney trauma on bilateral polycystic kidney disease: A case report.

作者信息

Angeli Anastasia Pearl, Wirjopranoto Soetojo, Azmi Yufi Aulia, Putra Antonius Galih Pranesdha, Soetanto Kevin Muliawan

机构信息

Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Department of Urology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

出版信息

Int J Surg Case Rep. 2024 Sep;122:110158. doi: 10.1016/j.ijscr.2024.110158. Epub 2024 Aug 13.

Abstract

BACKGROUND

The kidneys are the genitourinary organs most susceptible to trauma. One case is high-grade kidney trauma that can lead to kidney failure, such as Polycystic Kidney Disease (PKD). Here, we report a case of high-grade kidney trauma on PKD.

CASE REPORT

A 28-year-old man was involved in a traffic accident and was diagnosed with a left kidney rupture. There was minimal free fluid in the abdominal cavum and left pleural effusion. The results of USG in the left kidney showed a rupture in the posterior part of the cortex-medulla reaching the calyx, accompanied by a left posterior peri-renal hematoma and a PKD in the right kidney. In the CT scan examination, the hematoma extended to the lower left retroperitoneum and peripancreatic. The size of the left kidney was enlarged. In the right kidney, PKD was accompanied by an enlargement of the kidney size, but no rupture was obtained. Patient had been diagnosed with high-grade kidney trauma (AAST Grade IV). The patient was given conservative therapy. He was alive and discharged from the hospital.

CLINICAL DISCUSSION

Non-operative management (NOM) is the standard in kidney trauma management, with good outcomes in preventing morbidity and mortality. The trend toward this procedure results in a decrease in the number of unnecessary nephrectomies and a potential improvement in the quality of patient inhalation. Ultrasound and CT scan examinations are important markers.

CONCLUSION

The management of high-grade kidney trauma on PKD can be carried out conservatively and show good patient outcomes.

摘要

背景

肾脏是最易受创伤的泌尿生殖器官。一种情况是严重的肾脏创伤,可导致肾衰竭,如多囊肾病(PKD)。在此,我们报告一例多囊肾病合并严重肾脏创伤的病例。

病例报告

一名28岁男性遭遇交通事故,被诊断为左肾破裂。腹腔内有少量游离液体,左侧胸腔积液。左肾超声检查结果显示皮质 - 髓质后部破裂至肾盏,伴有左肾后周血肿,右肾有多囊肾病。CT扫描检查显示血肿延伸至左下腹后腹膜和胰腺周围。左肾体积增大。右肾多囊肾病伴有肾脏体积增大,但未发现破裂。患者被诊断为严重肾脏创伤(美国创伤外科学会IV级)。患者接受了保守治疗。他存活并出院。

临床讨论

非手术治疗(NOM)是肾脏创伤治疗的标准方法,在预防发病率和死亡率方面有良好效果。这种治疗方法的趋势减少了不必要的肾切除术数量,并可能改善患者的吸入质量。超声和CT扫描检查是重要的诊断依据。

结论

多囊肾病合并严重肾脏创伤可以进行保守治疗,并取得良好的患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d65/11382200/188147446491/gr1.jpg

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