Mountney J, Chapple C R, Johnson A G
Department of Orthopaedic Surgery, Southampton General Hospital, Southampton, UK.
Urol Int. 1998;61(2):121-3. doi: 10.1159/000030302.
We report a complex case in which the left kidney had undergone giant hydronephrotic change after chronic obstruction at the vesicoureteric junction. Minor blunt abdominal trauma caused rupture of the parenchyma of this expanded and dilated kidney, with bleeding into its collecting system. The mixture of blood and urine remained contained within the kidney's structural layers, so producing a tense, cystic, fluid-filled mass arising from the left hypochondrium. Pathogenesis, differential diagnosis and investigation of giant hydronephrosis and its rupture are discussed. The observation is made that gross distortion of the renal parenchyma by rupture or hydronephrosis impairs arterial inflow to the kidney.
我们报告了一例复杂病例，该病例中左肾在膀胱输尿管连接处慢性梗阻后发生了巨大肾积水性改变。轻微的腹部钝性外伤导致这个扩张和肿大的肾脏实质破裂，血液进入其集合系统。血液和尿液的混合物仍局限于肾脏的结构层内，从而在左季肋部形成了一个紧张的、囊性的、充满液体的肿块。本文讨论了巨大肾积水及其破裂的发病机制、鉴别诊断和检查。观察发现，破裂或肾积水导致的肾实质严重变形会损害肾脏的动脉血流。
