经皮肾造口术中十二指肠损伤的保守处理:泌尿学文献中的一些并发症。

Case Reports in Urology Pub Date : 2021-12-31 eCollection Date: 2021-01-01 DOI:10.1155/2021/8221488
Aykut Colakerol, Mustafa Zafer Temiz, Mubarek Bargicho Adem, Kamil Ozdogan, Fatih Celebi, Engin Kandirali, Ahmet Yaser Muslumanoglu
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引用次数: 0

摘要

在此,我们报告一个十二指肠穿孔的情况下,肠道损伤在经皮肾造口术。一名73岁的妇女,双侧肾造瘘导管应用于急诊服务,右侧疼痛。当天早些时候,她换了双侧肾造瘘导管。体格检查,右象限有防御和反弹,肋椎角压痛也呈阳性。腹部ct增强扫描显示,右肾造瘘导管位于十二指肠第二段,造影剂未从损伤区渗漏至腹膜。我们决定对该病例采取保守治疗,通过每日血液检查和体格检查进行主动监测。为了防止十二指肠与皮肤之间的瘘,将十二指肠内的肾造瘘导管留下,并在右肾内放置一根新的肾造瘘导管。应用广谱抗生素治疗方案,并密切随访患者。第20天,十二指肠导管顺利取出,第24天,患者顺利出院,双侧永久性肾造瘘管。在一个月后的第一次随访中,患者没有主动的医疗投诉。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Conservative Management of the Duodenal Injury during Percutaneous Nephrostomy Placement: A Few and Far between Complications of the Urological Literature.

Conservative Management of the Duodenal Injury during Percutaneous Nephrostomy Placement: A Few and Far between Complications of the Urological Literature.

Conservative Management of the Duodenal Injury during Percutaneous Nephrostomy Placement: A Few and Far between Complications of the Urological Literature.

Herein, we reported a duodenal perforation case as an intestinal injury during a percutaneous nephrostomy procedure. A 73-year-old woman with bilateral nephrostomy catheters was applied to the emergency service with right flank pain. Early in the day, her bilateral nephrostomy catheters had been changed. On physical examination, she had a defense and rebound at her right quadrant, and costovertebral angle tenderness was also positive. In the contrast-enhanced abdominal computed tomography scan, the right nephrostomy catheter was located in the second part of the duodenum, and the contrast agent did not leak into the peritoneum from the injury area. We decided on conservative management of the case with active surveillance using daily blood tests and physical examinations. The nephrostomy catheter in the duodenum was left to prevent fistula between the duodenum and the skin, and a new one was placed in the right kidney. The broad spectrum antibiotherapy regime was applied, and the patient was followed up closely. The catheter in the duodenum was removed on the 20th day, uneventfully, and the patient was discharged successfully on the 24th day with her permanent bilateral nephrostomy tubes. On the first follow-up, one month later, the patient had no active medical complaint.

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