腎動脈支架用於治療創傷造成的完全腎動脈阻塞：病例報告
方琬云 石宏仁 王百孚
彰化基督教醫院 泌尿科
Renal Artery Stenting for traumatic total renal artery occlusion: A case report
Wan-Yun Fang, Hung-Jen Shih, Pai-Fu Wang
Division of Urology, Department of Surgery, Changhua Christian Hospital
Introduction:
Renal artery occlusion after blunt trauma is a rare occurrence, and the optimal treatment for this condition has not been established. We report a man presenting with total occlusion of the left renal artery after a significant crush injury. He was successfully treated by percutaneous placement of an endovascular stent.
Case report:
A 52-year-old male without known chronic disease was sent to emergency department because of traumatic abdominal crush injury. The patient had been caught in the middle between machinery and vehicle. Severe chest pain and back pain were noted. Chest computer tomography (CT) with contrast was performed and revealed right 8th~10th ribs fracture and no contrast enhancement of left kidney. Laboratory data revealed leukocytosis, poor renal function and poor liver function. Right side chest tube was inserted for pneumothorax. Abdomen CT revealed left renal artery occlusion at proximal level and hematoma in left retroperitoneum, laceration of right liver parenchyma, hematoma in right adrenal gland, fracture of right 7th-11th ribs. Vital sign was stable. We consulted radiologist and arranged percutaneous transluminal angiography with stent insertion. Total occlusion of left renal artery due to dissection at proximal portion of left renal artery was found and an Express 7mm x 27mm stent was placed at proximal portion of left renal artery smoothly. At follow-up 2 months later, the patient has normal urinary output and a normal creatinine.
Conclusion:
Renal artery stenting is a treatment choice for total renal artery occlusion.