Spontaneous Renal Hemorrhage: Unusual Complication of Urinary Tract Infection

自發性腎臟出血：不尋常的泌尿道感染併發症

李坤峰(Kun-Feng Lee) ； 葉瑞圻(Jui-Chi Yeh) ； 陳漢湘(Han-Hsiang Chen) ； 吳志仁(Chih-Jen Wu) ； 陳逸洲(Yi-Chou Chen)

《內科學誌》 17卷4期 (2006/08) Pp. 177-181

https://doi.org/10.6314/JIMT.2006.17(4).05

摘要

泌尿道感染時，自發性腎臟出血是不尋常且非常嚴重的併發症。本篇病例報告一位糖尿病腎病變的73歲女性，因為發燒及間斷性的腹痛已一天，且檢驗出膿尿需住院接受治療，初步的腹部超音波顯示兩側腎臟萎縮，其餘並無特別異常。之後因病患發生嚴重的腹痛，且檢驗出血色素下降，電腦斷層掃描顯示右側腎臟出血，進而施行右側腎臟切除手術，證實右側腎臟有出血及膿瘍的情形，儘管術後給予積極治療，該病患十天後仍因術後併發症死亡。要正確地診斷並處理自發性腎臟出血需要立即的影像學檢查，當中以電腦斷層掃描是最佳的選擇。

並列摘要

Spontaneous renal hemorrhage is an unusual and severe complication of urinary tract infection. A 73-year-old woman with diabetic nephropathy was admitted with fever and intermittent abdominal pain for one day. She had pyuria and was treated for a presumed urinary tract infection. Initial abdominal ultrasonography showed only bilateral renal atrophy. Subsequently, she developed more severe abdominal pain and her hemoglobin dropped. Computed tomography showed a right perirenal hemorrhage. A right nephrectomy was performed, revealing both a perirenal hemorrhage and abscess. Postoperatively, various complications intervened and the patient died 10 days later. In conclusion, accurate diagnosis of spontaneous renal hemorrhage requires prompt immediate imaging studies to guide the management, and computed tomography is the procedure of choice.

並列關鍵字

Renal hemorrhage ； Complicated urinary tract infection ； Pyelonephritis ； Renal abscess