動脈塞栓術により治癒した穿通性腎外傷後の腎仮性動脈瘤の1例

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A 21-year-old man was brought to our hospital for a single stab wound in the left flankinflicted with a suicidal intent. The initial computed tomographic (CT) scan of the patient with hypotension revealed a perirenal hematoma. Laparotomy was carried out in order to rule out any wounds of intra-abdominal organs. There was no active bleeding in any intraperitoneal organs, but a stab wound in the left renal lower pole, 2 cm in length, was recognized and considered as the cause of the hematoma. Therefore, the wound of the renal parenchyma, which was accompanied by neither urinary leakage nor fresh bleeding, was closed. The patient received a blood transfusion, because gross hematuria appeared three days postoperatively and severe anemia ensued. Then, enhanced CT scan revealed a left intrarenal pseudoaneurysm. By the following arterial angiography the renal pseudoaneurysm with arteriovenous fistula was confirmed and successfully occluded using selective arterial embolization twice. Transcatheter arterial embolization is considered safe and effective and should be chosen as a first-line therapy for controlling hemorrhage from renal arterial pseudoaneurysms.
泌尿器科紀要刊行会の論文