2012 - 2019年钝性创伤后猫输尿管破裂伴输尿管外尿瘤:5例输尿管改道治疗的临床表现及远期疗效

IF 1.1 4区 农林科学 Q3 VETERINARY SCIENCES
B Dekerle, A Fournet, E Maurice, V Viateau, C Maurey, M Manassero
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引用次数: 0

摘要

病例史:回顾了2012年至2019年期间使用尿分流手术治疗外伤性输尿管破裂(TUR)的猫的医疗记录。临床发现和治疗:5只猫出现了与道路交通事故相关的伤害。其中包括三只需要手术治疗的腹部疝猫。事故发生后15天内,猫表现为嗜睡、腹部肿块或下尿路症状,所有猫的对比诊断成像均显示单侧TUR近端伴输尿管旁尿瘤。四只猫接受了皮下输尿管旁路(SUB)装置放置,一只在支架上进行输尿管吻合。在所有猫中均观察到单侧囊肿样腹膜后积液与输尿管外尿瘤一致,在四只猫中观察到弥漫性腹膜后血肿。没有立即发生重大并发症,所有猫术后血清肌酐浓度在参考区间内。接受输尿管支架的猫在术后15个月支架结痂后需要放置SUB。中位随访时间为34个月(最短28个月,最长58个月),最后一次随访时所有猫的肾功能正常。临床相关性:在这5只猫的近端TUR术后,尿转移手术提供了长期稳定的肾功能。高能量钝性创伤引起腹部疝并伴有弥漫性腹膜后血肿后出现延迟的、细微的非特异性临床症状,应引起对TUR的怀疑。缩写:AFAST:腹部创伤超声聚焦评估;SUB:输尿管旁路术;TUR:外伤性输尿管破裂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Feline ureteral rupture with para-ureteral urinomas following blunt trauma: clinical presentation and long-term outcome after treatment by urinary diversion for five cases from 2012 to 2019.
ABSTRACT Case history Medical records were reviewed for cats that underwent surgical treatment of traumatic ureteral rupture (TUR) using urinary diversion procedures between 2012 and 2019. Clinical findings and treatment Five cats had presented with injuries associated with road traffic accidents. These included three cats with abdominal hernias that required surgical management. At a median of 15 days after the accident, cats represented with lethargy, the presence of an abdominal mass or with lower urinary tract symptoms and in all cats contrast diagnostic imaging showed proximal unilateral TUR with associated para-ureteral urinoma. Four cats received subcutaneous ureteral bypass (SUB) device placement and one had ureteral anastomosis over a stent. Unilateral cyst-like retroperitoneal fluid consistent with para-ureteral urinoma was observed in all cats and a diffuse retroperitoneal haematoma was noticed in four cats. No immediate major complications occurred, and all cats had post-operative serum creatinine concentration within the reference interval. The cat that had received a ureteral stent subsequently required placement of a SUB following stent encrustation 15 months after surgery. Median follow-up time was 34 (min 28, max 58) months and renal function was normal in all cats at the last follow-up. Clinical relevance Urinary diversion procedures provided long-term stable renal function following proximal TUR in these five cats. Delayed, subtle non-specific clinical signs subsequent to high-energy blunt trauma causing abdominal hernia and associated diffuse retroperitoneal haematoma, should raise suspicion of TUR. Abbreviations AFAST: Abdominal focused assessment with sonography for trauma; SUB: Subcutaneous ureteral bypass; TUR: Traumatic ureteral rupture
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来源期刊
New Zealand veterinary journal
New Zealand veterinary journal 农林科学-兽医学
CiteScore
3.00
自引率
0.00%
发文量
37
审稿时长
12-24 weeks
期刊介绍: The New Zealand Veterinary Journal (NZVJ) is an international journal publishing high quality peer-reviewed articles covering all aspects of veterinary science, including clinical practice, animal welfare and animal health. The NZVJ publishes original research findings, clinical communications (including novel case reports and case series), rapid communications, correspondence and review articles, originating from New Zealand and internationally. Topics should be relevant to, but not limited to, New Zealand veterinary and animal science communities, and include the disciplines of infectious disease, medicine, surgery and the health, management and welfare of production and companion animals, horses and New Zealand wildlife. All submissions are expected to meet the highest ethical and welfare standards, as detailed in the Journal’s instructions for authors.
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