個案報告:第五級腎臟外傷採取非手術治療之成效
林才揚、陳俊豪、沈坤宏
奇美醫學中心 外科部 泌尿科
Case report: non-operative management for grade V kidney injury
Chye-Yang Lim, Chun-Hao Chen, Kun-Hung Shen
Divisions of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
Case description:
This is a 18 years old male with the history of traumatic head injury status post craniectomy twice. He was suffered from traffic accident which result in grade V shattered kidney with peripheral hematoma without CT evidence of contrast extravasation. Then conservative treatment given with Cefazolin and Foley indwelled.After PRBC 2U transfusion, his hemoglobin dropped gradually but static at the level of 11 g/dL.
Abdominal CT follow up on post-traumatic day 8 disclosed urinary leakage at right collecting system. After that, gross hematuria with intense right flank pain noted, so abdominal CT done again which suspicious of active bleeding. Therefore angiography arranged but there was no evidence of active bleeding. As right urinoma formation with leukocytosis, pigtail inserted for drainage. Meanwhile right JJ stent indwelled retrogradely too. The patient was discharged smoothly without any complications.