| 摘要 |
Traumatic renal artery injury is an unusual result of blunt trauma. No meaningful
recommendation has been established for optimal management of blunt renal artery
injury on account of a small number of cases.Early diagnosis, however is important
and advocated early management at present includes nephrectomy, revascularization,
endovascular stenting, thrombolytic agent administration and careful
observation of blunt renovascular injuries.
A 60 year-old male suffered from a traffic accident when he drove a car and hit a
telephone pole three days before. He was brought to the emergency department of a
local hospital for first aid. He was then discharged to go home. However, gross
hematuria was noted three days later and he came to our hospital. His vital signs
were relatively stable at that time. (heart rate: 96/min, blood pressure 120/88mmHg,
body temperature 36.7°C and respiratory rate: 18/min). Poor contrast perfusion in
the left kidney was revealed on abdominal computed tomography. Dissecting injury
of the renal artery was suspected. After performance of the first arteriography
showing left renal artery occlusion, renal artery occlusion progressed and the lumen
could not be identified during the second arteriography, which revealed total
occlusion of the left renal artery. The patient received conservative therapy, and
there was no further complication during his follow up at the outpatient department.
Early diagnosis and early management will result in better recovery of the renal
function. Computed tomography scan can be considered as the first choice of
examination for diagnosis because of its high sensitivity and specificity. |
