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采用无血管入路的开放性肾切开取石术后肾下极节段动脉假性动脉瘤:一例报告

Pseudoaneurysm of the lower pole segmental artery of the kidney following open nephrolithotomy using an avascular approach: a case report.

作者信息

Kazemi Reza, Jandaghi Faezeh Sadat, Jannesari Ahmadreza, Montazeri Farzaneh

机构信息

Department of Urology, Isfahan University of Medical Sciences Isfahan, Iran.

Department of Urology, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences Isfahan, Iran.

出版信息

Am J Clin Exp Urol. 2025 Feb 15;13(1):51-56. doi: 10.62347/XYVA5477. eCollection 2025.

Abstract

Aneurysms are abnormalities in blood vessels that can be categorized as true aneurysms or pseudoaneurysms. Pseudoaneurysms occur when one or more layers of the blood vessel wall rupture, often as a result of trauma or medical procedures, such as nephrolithotomy. This case study discusses a pseudoaneurysm of the lower pole segmental artery of the kidney that developed after an open nephrolithotomy despite an avascular surgical plan. The patient experienced intermittent gross hematuria, highlighting the potential complications associated with renal surgeries. The diagnosis was challenging, necessitating a high suspicion index and imaging modalities such as ultrasound, CT scans, and angiography. Treatment options varied from conservative management to angioembolization, which is preferred for its minimally invasive nature and ability to preserve renal parenchyma. This study aims to demonstrate that the risk of pseudoaneurysm should be considered even in an atrophic nephrolithotomy performed without vascular invasion.

摘要

动脉瘤是血管中的异常情况,可分为真性动脉瘤或假性动脉瘤。假性动脉瘤发生在血管壁的一层或多层破裂时,通常是由于外伤或医疗程序,如肾切开取石术。本病例研究讨论了一例开放性肾切开取石术后发生的肾下极段动脉假性动脉瘤,尽管手术计划为无血管操作。患者出现间歇性肉眼血尿,突出了肾手术相关的潜在并发症。诊断具有挑战性,需要高度的怀疑指数以及超声、CT扫描和血管造影等成像方式。治疗选择从保守治疗到血管栓塞不等,血管栓塞因其微创性质和保留肾实质的能力而更受青睐。本研究旨在表明,即使在无血管侵犯的萎缩性肾切开取石术中,也应考虑假性动脉瘤的风险。

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