Walters B L, Grunau C F, Parman S C
Ann Emerg Med. 1985 Jun;14(6):607-10. doi: 10.1016/s0196-0644(85)80793-9.
A 57-year-old woman with an extensive cardiac history presented complaining of left flank pain. An intravenous pyelogram performed for the presumptive diagnosis of renal calculus showed poor function of the left kidney. Angiography demonstrated a 95% obstructing embolus in the left renal artery, which was removed surgically. This case illustrates some of the pitfalls in the diagnosis of renal artery obstruction and the need for a high index of suspicion. The intrarenal infusion of thrombolytic agents such as streptokinase may become the treatment of choice despite the success of surgical embolectomy. The diagnosis, laboratory analysis, and treatment of renal artery obstruction is discussed.
一名有广泛心脏病史的57岁女性因左侧胁腹疼痛前来就诊。为初步诊断肾结石而进行的静脉肾盂造影显示左肾功能不佳。血管造影显示左肾动脉有一个95%阻塞性栓子，通过手术将其取出。该病例说明了肾动脉阻塞诊断中的一些陷阱以及高度怀疑的必要性。尽管手术取栓成功，但肾内输注链激酶等溶栓剂可能会成为首选治疗方法。本文讨论了肾动脉阻塞的诊断、实验室分析和治疗。
