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腹膜后肿块导致的梗阻后急性肾损伤

Post-obstructive Acute Kidney Injury Due to a Retroperitoneal Mass.

作者信息

Athar Zoraize Moeez, Arshad Mahnoor, Davis Gabrielle, Epperson Jacob, Uday Kalpana A

机构信息

Internal Medicine, BronxCare Health System, New York City, USA.

Internal Medicine, American University of the Caribbean, Cupecoy, SXM.

出版信息

Cureus. 2025 Apr 10;17(4):e82007. doi: 10.7759/cureus.82007. eCollection 2025 Apr.

Abstract

This case report discusses post-obstructive acute kidney injury (AKI) in a 26-year-old woman with neurofibromatosis type 1 (NF1) and uterine fibroids. The patient's AKI was diagnosed through elevated creatinine and blood urea nitrogen (BUN) levels and confirmed by transabdominal ultrasound and computed tomography (CT) scan, which revealed severe bilateral ureterohydronephrosis. The patient underwent fluoroscopic and sonographic bilateral nephrostomy tube placement, which significantly improved renal function. An exploratory laparotomy and superficial mass biopsy indicated a retroperitoneal tumor consisting of fibroadipose and muscular tissue with focal suppurative inflammation. The patient's renal function normalized by discharge. This case underscores the importance of early recognition, radiological evaluation, and timely intervention in managing AKI secondary to obstructive uropathy and calls for further research on optimal management strategies for AKI secondary to primary retroperitoneal masses.

摘要

本病例报告讨论了一名患有1型神经纤维瘤病(NF1)和子宫肌瘤的26岁女性的梗阻后急性肾损伤(AKI)。通过肌酐和血尿素氮(BUN)水平升高诊断出该患者的AKI,并经腹部超声和计算机断层扫描(CT)证实,结果显示严重的双侧输尿管肾盂积水。患者接受了荧光镜和超声引导下的双侧肾造瘘管置入术,肾功能得到显著改善。剖腹探查和浅表肿块活检显示为一个由纤维脂肪和肌肉组织组成的腹膜后肿瘤,并伴有局灶性化脓性炎症。患者出院时肾功能恢复正常。本病例强调了早期识别、影像学评估和及时干预在处理梗阻性肾病继发的AKI中的重要性,并呼吁对原发性腹膜后肿块继发的AKI的最佳管理策略进行进一步研究。

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