Wagenknecht L V
Urologe A. 1977 Jan;16(1):9-14.
Traumatic kidney injuries are the most frequent causes of retroperitoneal hematoma. The intensity of hematuria among other symptoms does not always correspond to the severity of the lesion. Apart from the i.v. urogram as the first screening test, angiography is the most important diagnostic criterion for the estimation of the degree of severity of the injury and in deciding whether or not surgery is necessary. Hemorrhage makes immediate surgery necessary in 10 - 20% of kidney ruptures. In contrast to the combined urohematoma, the simple hematoma is usually absorbed. Secondary complications make drainage or nephrectomy essential. The rupture of the venal vascular peduncle and ruptures of renal arterial aneurysms are seen seldom and are usually fatal. The mortality rate for urohematomas caused by rupture of the bladder/urethra increases, the longer corrective surgery is postponed. Clinically relevant retroperitoneal hematomas after kidney biopsies, operations on the renal parenchyma, and after vascular injuries resulting from angiography are relatively infrequent and require a specific therapy, according to the individual case.
创伤性肾损伤是腹膜后血肿最常见的原因。血尿的严重程度以及其他症状并不总是与损伤的严重程度相对应。除了静脉肾盂造影作为初步筛查检查外，血管造影是评估损伤严重程度以及决定是否需要手术的最重要诊断标准。在10% - 20%的肾破裂病例中，出血使得立即手术成为必要。与合并尿血肿不同，单纯血肿通常会被吸收。继发性并发症使得引流或肾切除术成为必需。肾静脉血管蒂破裂和肾动脉动脉瘤破裂很少见，通常是致命的。膀胱/尿道破裂导致的尿血肿，矫正手术推迟的时间越长，死亡率越高。肾活检、肾实质手术以及血管造影导致的血管损伤后出现的具有临床意义的腹膜后血肿相对少见，需要根据具体情况进行特定治疗。
