Mibu H, Kagebayashi Y, Tanaka M, Kim S C, Yoshii M, Fujimoto K, Ozono S, Hirao Y
Department of Urology, Nara Medical University.
Hinyokika Kiyo. 1998 May;44(5):327-30.
Avulsion of ureter without renal injury is rarely caused by blunt trauma, only 28 cases having been reported in Japan. A 33-year-old male was admitted to our hospital 1 month after blunt abdominal trauma at work. He complained of left flank pain and macroscopic hematuria. Under the suspicion of renal or ureteral injury, drip infusion urography and abdominal computerized tomography revealed an extravasation from the left upper ureter and urinoma formation in the retroperitoneal cavity. In order to reduce the inflammation, the urinoma was drained. The retrograde pyelogram revealed complete obstruction at the left upper ureter, 20 cm from the left ureteral orifice. Urinary tract reconstruction, end-to-end ureteral anastomosis, was performed under the diagnosis of left ureteral avulsion. Drip infusion urography revealed normal ureteral healing without stricture formation at 2 years after reconstruction.
输尿管撕脱而无肾损伤很少由钝性创伤引起，在日本仅报道过28例。一名33岁男性在工作中腹部受到钝性创伤1个月后入住我院。他主诉左胁腹疼痛和肉眼血尿。怀疑有肾或输尿管损伤，经静脉滴注尿路造影和腹部计算机断层扫描显示左输尿管上段有造影剂外渗，腹膜后腔有尿瘤形成。为减轻炎症，对尿瘤进行了引流。逆行肾盂造影显示左输尿管上段距左输尿管口20 cm处完全梗阻。在诊断为左输尿管撕脱后，进行了尿路重建，即输尿管端端吻合术。重建术后2年，静脉滴注尿路造影显示输尿管愈合正常，无狭窄形成。
