Zhang Zhengyi, Ding Peng, Yang Meijie, Zhou Xiujuan, Long Kunlan
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Department of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Med (Lausanne). 2025 Jul 15;12:1574196. doi: 10.3389/fmed.2025.1574196. eCollection 2025.
Urogenic sepsis is a systemic inflammatory response syndrome triggered by infections of the genitourinary tract. It is characterized by complex etiology, atypical clinical symptoms, rapid disease progression, and difficulty in treatment, making it a focal point and challenge in clinical diagnosis and therapy. Although endovascular interventions are effective in treating conditions such as iliac artery thrombosis, they can also lead to complications such as arterial rupture and subsequent hematoma formation. This article reports a rare case of urogenic sepsis that developed secondary to urinary tract obstruction and infection caused by compression of the ureter due to an iatrogenic retroperitoneal hematoma following endovascular surgery.
A 63-year-old male patient was admitted to the hospital with symptoms of severe viral pneumonia and acute heart failure. Two months earlier, the patient had undergone a vascular interventional procedure, during which a rupture of the left iliac artery led to the formation of an intra-abdominal hematoma, a condition that was not given due attention at the time. Although initial treatment was provided for the respiratory and cardiac issues, the patient's condition continued to deteriorate. Subsequent examinations revealed that the hematoma was compressing the ureters, causing severe ureteral obstruction and urinary sepsis. The patient then underwent an emergency transurethral ureteral stent implantation. Following the procedure, the patient's condition significantly improved, and he was eventually discharged from the hospital.
Cases of iatrogenic intraperitoneal hematoma compressing the ureters and subsequently causing urogenic sepsis are extremely rare in clinical practice. This case highlights the necessity of early identification and intervention of iatrogenic complications, especially in the patient population with a history of vascular interventional surgery. It underscores the crucial role of targeted diagnostic strategies and surgical interventions in resolving the challenge of mechanical obstruction. The research findings indicate that it is essential to establish a multidisciplinary collaborative mechanism to effectively manage such complex cases.
泌尿源性脓毒症是由泌尿生殖道感染引发的全身炎症反应综合征。其病因复杂，临床症状不典型，疾病进展迅速且治疗困难，是临床诊断和治疗的重点与挑战。尽管血管内介入治疗在治疗诸如髂动脉血栓形成等病症方面有效，但也可能导致动脉破裂及随后的血肿形成等并发症。本文报道了一例罕见的泌尿源性脓毒症病例，该病例继发于血管内手术后因医源性腹膜后血肿压迫输尿管导致的尿路梗阻和感染。
一名63岁男性患者因严重病毒性肺炎和急性心力衰竭症状入院。两个月前，该患者接受了一次血管介入手术，术中左髂动脉破裂导致腹腔内血肿形成，当时这一情况未得到应有的重视。尽管对呼吸和心脏问题进行了初步治疗，但患者病情仍持续恶化。随后检查发现血肿压迫输尿管，导致严重的输尿管梗阻和尿脓毒症。该患者随后接受了紧急经尿道输尿管支架植入术。术后，患者病情明显改善，最终出院。
医源性腹腔内血肿压迫输尿管并随后导致泌尿源性脓毒症的病例在临床实践中极为罕见。该病例凸显了早期识别和干预医源性并发症的必要性，尤其是在有血管介入手术史的患者群体中。它强调了针对性诊断策略和手术干预在解决机械性梗阻挑战方面的关键作用。研究结果表明，建立多学科协作机制以有效管理此类复杂病例至关重要。
