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首页> 美国卫生研究院文献>Journal of Endourology Case Reports >Perinephric Hematoma and Hemorrhagic Shock as a Rare Presentation for an Acutely Obstructive Ureteral Stone with Forniceal Rupture: A Case Report
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Perinephric Hematoma and Hemorrhagic Shock as a Rare Presentation for an Acutely Obstructive Ureteral Stone with Forniceal Rupture: A Case Report

机译：肾盂血肿和出血性休克作为急性梗阻性输尿管结石的罕见表现：一例报告

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>Background: Spontaneous perinephric hematoma (SPH) secondary to a forniceal rupture as the first presenting sign for an obstructive ureteral stone in a patient without history of urolithiasis has not been described previously.>Case presentation: We report a 70-year-old Caucasian male patient who presented to our emergency room with fever, altered mental status, and left flank pain. He had a temperature of 103.3°F, tachycardia, but stable blood pressure. He had left flank tenderness. A computed tomography scan of the abdomen/pelvis with intravenous contrast revealed an intracapsular hematoma (13.3 × 10.0 × 6.4 cm) with an active bleeding and a 1.1 cm left proximal ureteral stone. The patient became quickly hemodynamically unstable and was taken for emergent exploratory laparotomy and left nephrectomy. An active bleeding was encountered secondary to a (2.4 × 2.0 cm) lateral capsular defect in the kidney.>Conclusion: Hemorrhagic/septic shock as a presenting sign for an obstructive ureteral stone may require an emergent nephrectomy in a hemodynamically unstable patient.
机译：>背景：以前没有描述过继发于前庭破裂的自发性会阴性血肿（SPH），这是无尿路结石病史的患者阻塞性输尿管结石的首个表现。>病例表现：< / strong>我们报告了一名70岁的白人男性患者，他因发烧，精神状态改变和左胁腹痛而出现在我们的急诊室。他的体温为103.3°F，心动过速，但血压稳定。他左胁骨柔软。腹部/骨盆的计算机断层扫描与静脉造影结果显示，囊内血肿（13.3×10.0×6.4 cm）有活动性出血，左近侧输尿管结石为1.1 cm。该患者很快血流动力学不稳定，并接受了紧急探查剖腹术和左肾切除术。继发于肾脏（2.4×2.0 cm）外侧囊膜缺损后发生活动性出血。>结论：出血/败血性休克是梗阻性输尿管结石的表现，可能需要在急诊行肾切除术血液动力学不稳定的患者。

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