Kikuchi E, Tanomogi H, Hasegawa S, Nakamura F
Department of Urology, Tochigi National Hospital.
Hinyokika Kiyo. 1998 Jul;44(7):497-9.
A 17-year-old man, who had previously been followed for Nutcracker phenomenon, presented with back pain and gross hematuria. As he developed tamponade of the urinary bladder repeatedly, and the hemoglobin level decreased, we thus performed emergency angiography. A selective left renal venogram revealed the left renal vein to be compressed between the superior mesenteric artery and the abdominal aorta, while the development of an extensive peri- and para-renal collateral circulation was also observed. We next performed epinephrine pharmacoangiography in order to better visualize any abnormal vessels. A left renal arteriovenous fistula was thus diagnosed by this method, and treated successfully by transcatheter embolization using a platinum coil.
一名17岁男性，此前因胡桃夹现象接受随访，现出现背痛和肉眼血尿。由于他反复出现膀胱填塞，且血红蛋白水平下降，我们因此进行了急诊血管造影。选择性左肾静脉造影显示左肾静脉被肠系膜上动脉和腹主动脉压迫，同时还观察到广泛的肾周和肾旁侧支循环形成。接下来，我们进行了肾上腺素药物血管造影，以便更好地观察任何异常血管。通过这种方法诊断出左肾动静脉瘘，并使用铂金线圈经导管栓塞成功治疗。
