Evans R A, Smith M J
J Trauma. 1976 Jul;16(7):558-61. doi: 10.1097/00005373-197607000-00007.
Frequently traumatic injury to the renal pelvis or upper ureter is overshadowed by multiple associated injuries. The diagnosis may be particularly difficult, due to the lack of hematuria and absence of pathognomonic findings. All too frequently the delayed manifestations of urinary wound drainage, retroperitoneal mass, or urinary ascites and sepsis first draw attention to the ureteral injury. A review of the problem and our experience with 16 such injuries is presented. As with other infrequent injuries the single and most important diagnostic factor is the prepared mind of the examiner. We feel all patients who have penetrating abdominal trauma, have fractured lumbar processes, or are involved in accidents where deceleration or extension occur should have infusion pyelography even in the absence of hematuria.
肾盂或上段输尿管的创伤性损伤常常被多种合并伤所掩盖。由于缺乏血尿以及特异性体征，诊断可能会特别困难。尿路伤口引流、腹膜后肿块、尿腹水和败血症的延迟表现往往首先引起对输尿管损伤的关注。本文综述了这一问题以及我们对16例此类损伤的经验。与其他罕见损伤一样，唯一也是最重要的诊断因素是检查者的警惕性。我们认为，所有腹部穿透伤、腰椎骨折或经历过减速或伸展事故的患者，即使没有血尿，也应进行静脉肾盂造影。
