Cass A S, Luxenberg M, Gleich P, Smith C
Urology. 1985 Sep;26(3):249-51. doi: 10.1016/0090-4295(85)90120-7.
The significance of extravasation of dye during excretion urography in blunt renal injuries has been controversial, with some believing that extravasation, even if copious, is largely innocuous and characterized by spontaneous resolution, and others believing extravasation is an indication for surgical correction of the underlying blunt renal injury. Thirty-two patients with extravasation diagnosed on excretion urography after blunt external trauma were evaluated. Immediate surgical management of the renal injury was performed in 18 patients who had a contusion in 1, laceration in 13, rupture in 3, and pedicle injury in 1, and averaged 2.0 associated injuries per patient. Conservative management of the renal injury was performed in 14 patients who averaged 1.1 associated injuries per patient. Ten of the 14 patients had a large renal laceration splitting the kidney or disrupting a pole with extravasation and none settled to normal. The data showed that extravasation with a small laceration resolved spontaneously while extravasation with a major disruption of the kidney did not settle to normal.
排泄性尿路造影时染料外渗在钝性肾损伤中的意义一直存在争议，一些人认为，即使染料外渗量很大，大多也是无害的，其特点是可自行消退，而另一些人则认为染料外渗是对潜在钝性肾损伤进行手术矫正的指征。对32例钝性外伤后经排泄性尿路造影诊断为染料外渗的患者进行了评估。18例肾损伤患者接受了肾损伤的即刻手术治疗，其中1例为挫伤，13例为裂伤，3例为破裂，1例为肾蒂损伤，每位患者平均有2.0处合并伤。14例肾损伤患者接受了保守治疗，每位患者平均有1.1处合并伤。14例患者中有10例存在大的肾裂伤，使肾脏裂开或使肾极断裂并伴有染料外渗，且无一例恢复正常。数据表明，小裂伤伴有的染料外渗可自行消退，而肾脏严重损伤伴有的染料外渗则不会恢复正常。
