Craig J C, Grigor W G, Knight J F
Department of Nephrology, Royal Alexandra Hospital for Children, Camperdown, Sydney, NSW, Australia.
Eur J Pediatr. 1994 May;153(5):369-71. doi: 10.1007/BF01956422.
We report a rare complication of ritual circumcision in an 8-week-old boy. He presented 1 week after the procedure with reduced urine output, a grossly distended bladder and marked bilateral hydroureteronephrosis on ultrasonography. The acute partial urinary obstruction was due to the dressing which was applied after surgical removal of the foreskin and to oedema of the glans. He had abnormal renal function (creatinine 85 mumol/l, urea 8.5 mmol/l) and a hyperkalaemic metabolic acidosis with hyponatraemia (Na 127 mmol/l, K 6.9 mmol/l, HCO3 16 mmol/l), which were attributed to obstructive uropathy. Because of prolonged secondary bladder dysfunction he required urinary catheterisation for 1 week. There was significant post obstructive diuresis and parenteral fluid therapy was given for 7 days. Whilst urinary retention is a well recognized complication of circumcision, this is the first report of significant obstructive uropathy and renal impairment due to surgical excision of the foreskin.
我们报告了一名8周大男童因宗教仪式割礼引发的罕见并发症。术后1周，他出现尿量减少，膀胱明显膨胀，超声检查显示双侧严重肾盂积水。急性部分尿路梗阻是由于包皮切除术后所敷的敷料以及龟头水肿所致。他的肾功能异常（肌酐85μmol/L，尿素8.5mmol/L），伴有高钾血症性代谢性酸中毒及低钠血症（钠127mmol/L，钾6.9mmol/L，碳酸氢根16mmol/L），这些均归因于梗阻性尿路病。由于继发性膀胱功能障碍持续时间较长，他需要留置导尿1周。出现了明显的梗阻后利尿，给予了7天的肠外补液治疗。虽然尿潴留是割礼公认的并发症，但这是首例因包皮手术切除导致严重梗阻性尿路病和肾功能损害的报告。
