Probst A, Harder F, Hofer H, Thiel G
Eur Urol. 1982;8(5):314-6. doi: 10.1159/000473542.
Severe femoral neuropathy subsequent to renal transplantation is described in a patient who died in the 5th postoperative week. Postmortem examination revealed a compression of the femoral nerve by an older hematoma of the iliac muscle, ipsilateral to the transplantation, and severe Wallerian degeneration of the nerve beginning at the site of the hematoma. It is postulated that the hematoma resulted from surgical trauma on the iliac muscle and was facilitated by previous anticoagulation and hypertensive vasculopathy. We suggest that every patient with similar symptoms occurring after renal transplantation should be investigated for a retroperitoneal hematoma. If such a hematoma is diagnosed, immediate decompression neurolysis should be performed in order to prevent prolonged recovery time or permanent disability.
一名在术后第5周死亡的肾移植患者出现了严重的股神经病变。尸检发现，移植同侧的髂肌陈旧性血肿压迫股神经，且神经自血肿部位开始出现严重的华勒氏变性。据推测，血肿是由髂肌手术创伤引起的，既往抗凝治疗和高血压性血管病变起到了促进作用。我们建议，对每一位肾移植后出现类似症状的患者都应排查是否存在腹膜后血肿。如果诊断出此类血肿，应立即进行减压神经松解术，以防止恢复时间延长或造成永久性残疾。
