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Acute Abdomen: A Case of Spontaneous Rupture of Renal Angiomyolipoma

急性腹症:一腎血管肌脂瘤自發性破裂病例

摘要


「急性腹症」對從事急診工作的醫生而言是一大挑戰,因腎血管肌脂瘤自發性破裂而造成需緊急剖腹探查的案例幷不多見,在此我們提出一個急性腹痛合幷血色素下降的病例,術前臆斷為穿孔性潰瘍;病人接受緊急剖腹探查術,手術中發現腹內出血來自於後腹腔內左腎上端的一個破裂腫瘤,在危急情况下病人接受全腎切除以挽救生命,之後的病理報告證實此腫瘤爲腎血管肌脂瘤。作者針對此腫瘤的臨床徵狀、診斷、及治療做一探討。

並列摘要


Managing the acute abdomen is a big challenge to clinicians in the emergency department. The spontaneous rupture of a renal angiomyolipoma requiring an emergency operation is occasionally encountered. We present a case of acute onset of extreme abdominal pain with a rapid decrease in her hemoglobin. Emergency exploratory celiotomy was performed under the impression of a perforated peptic ulcer with peritonitis. At surgery a retroperitoneal hemorrhage was found. The bleeding source was a ruptured mass, located at the upper pole of the left kidney. A life-saving total nephrectomy was carried out and pathology confirmed the tumor to be an angiomyolipoma. The clinical manifestations, diagnosis, and treatment of renal angiomyolipoma are briefly discussed.

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