腎臟動靜脈血管廔管:病例報告與文獻回顧
郭名翔1 洪順興1 劉建良2 沈坤宏2
奇美醫療財團法人佳里奇美醫院 外科部 泌尿外科1
奇美醫學中心 外科部 泌尿外科2
Arteriovenous fistulas of the kidney : Cases report and literature review
Ming-Hsiang Kuo1、 Shun-Hsing Hung 1、Chien-Liang Liu 2, Kun-Hung Shen 2
Department of Surgery, Division of Urology1, Chali Chi Mei Hospital, Tainan, Taiwan
Department of Surgery, Division of Urology2, Chi Mei Medical Center, Tainan, Taiwan
Introduction:
Arteriovenous fistulas of the kidney are rare and are classified as acquired, idiopathic or arising in a congenital arteriovenous malformation which may leading to hypertension and acute heart failure. The treatment of Renal Arteriovenous fistula aims at preserving the most of the renal parenchyma and, concomitantly, eradicating the symptoms and hemodynamic effects caused by the Renal Arteriovenous fistula.
We would like to introduce the cases of Renal Arteriovenous fistula in our hospital.
Method:
We search our cases by identifying the final diagnosis as Renal Arteriovenous fistula within recent 10 year period (2005~2015).
Case report:
Totally four cases were found as follows
|
|
Case1
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Case2
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Case3
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Ase4
|
|
Age
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44 y/o Female
|
77 y/o Female
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41 y/o Male
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21 y/o male
|
|
Underlying disease
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No
|
No
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HBV
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No
|
|
Presenting symptoms
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Hematuris
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Left flank soreness
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No symptoms
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Hematuris, fever, right flank pain
|
|
Involved kidney
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Right
|
Left
|
Right
|
Right
|
|
Diagnostic tool
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CT
|
CT
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CT
|
CT
|
|
Treatment
|
TAE
|
TAE
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TAE
|
TAE
|
|
Post treatment Cr
|
Normal
|
Normal
|
Normal
|
Normal
|
Conclusion
Arteriovenous fistulas of the kidney are rare and are classified as acquired, idiopathic or arising in a congenital arteriovenous malformation. All of our four cases are idiopathic with three of them are symptomatic. All of them treated successfully by TAE with symptoms relieved and hemodynamics were stable. No obvious damage of renal function were noticed. We would like to share our cases and compare with literatures published to give a whole picture of the disease in diagnosis, treatment and
Prognosis.