Bellamy J, Schrameck E, Benoit G, Brunschvicg O, Mohamedi D, Fries D, Charpentier B
Sem Hop. 1982 May 6;58(18):1123-6.
The authors describe five cases of renal allograft rupture as a result of acute rejection. In one case of perineal hematoma, no operation was performed. The evolution of the hematoma led to a periureteral sclerosis, which was successfully operated. The authors advocate deferring the surgical management of allograft ruptures. Once the diagnosis has been established with the aid of physical examination, electrography and computerized scanography, the extra time can be devoted to following the evolution of the rejection. If the rejection is irreversible, a nephrectomy has to be performed, but if it is reversible, they favour conservative treatment followed by operative intervention around the tenth day.
作者描述了5例因急性排斥反应导致肾移植破裂的病例。其中1例为会阴血肿,未进行手术。血肿的演变导致输尿管周围硬化,后成功进行了手术。作者主张推迟肾移植破裂的手术处理。一旦通过体格检查、电图检查和计算机扫描确诊,就可以利用额外的时间跟踪排斥反应的演变情况。如果排斥反应不可逆,就必须进行肾切除术,但如果是可逆的,他们倾向于保守治疗,然后在第十天左右进行手术干预。