Kim H J, Kim S W, Jang W Y, Kim Y S, Park C K
Department of Internal Medicine, Hanyang University Kuri Hospital, Korea.
J Korean Med Sci. 1998 Oct;13(5):551-3. doi: 10.3346/jkms.1998.13.5.551.
A case of subcapsular hematoma, a rare complication of acute pyelonephritis (APN) is described. A 60-year-old diabetic woman was admitted with a 3 day history of fever and left flank pain due to acute pyelonephritis. On the third day in hospital, left flank pain worsened despite use of antibiotics available for the treatments of APN and hemoglobin rapidly decreased from 11.1 to 7.9 g/dL. Ultrasonography and abdominal CT showed left subcapsular hematoma. Renal angiography demonstrated an ovoid avascular zone between the capsular artery and parenchyme of the left kidney with no evidence of tumors or vascular abnormalities, such as arteriovenous malformation or fistula. Subsequent percutaneous drainage of this subcapsular hematoma was performed and showed old blood-colored drainage. Hereby, the possibility of subcapsular renal hematoma in the course of acute pyelonephritis is stressed as a rare complication.
本文描述了一例急性肾盂肾炎（APN）的罕见并发症——肾包膜下血肿。一名60岁的糖尿病女性因急性肾盂肾炎入院，有3天的发热和左侧腰痛病史。住院第三天，尽管使用了治疗APN的抗生素，但左侧腰痛仍加重，血红蛋白迅速从11.1 g/dL降至7.9 g/dL。超声检查和腹部CT显示左侧肾包膜下血肿。肾血管造影显示左肾包膜动脉与实质之间有一个椭圆形无血管区，无肿瘤或血管异常迹象，如动静脉畸形或瘘管。随后对该肾包膜下血肿进行了经皮引流，引流液呈陈旧性血色。因此，强调了急性肾盂肾炎过程中发生肾包膜下血肿作为一种罕见并发症的可能性。
