腎外傷30症例の検討 CT・血管造影の有用性

Abstract

男25例, 女5例(平均33歳), 交通事故に因るもの19, 転落5, スポーツ外傷2であった.CTでは排泄性腎盂造影に比し異常所見検出に感度が高く, 重症度判定に有用である.保存的治療を行った27例は, 顕微鏡的血尿は腎挫傷で4.1日, 小裂傷で13日, 大裂傷で42日であった

To evaluate the diagnostic value of radiographic examinations in renal trauma, 30 patients treated between April, 1985 and March, 1988 were examined. The 25 male and 5 female patients ranged in age from 10 to 74 years, with 17 (57%) less than 30 years of age. Causes of injuries were traffic accidents in 19 patients (63%), falls in 5 (17%), sports in 2 (7%), and others in 4 (13%). Twenty-nine patients (97%) had hematuria and 3 (10%) had shock due to renal injury. The presence of shock indicated severe renal injury, but the degree of hematuria did not correlate to severity of injury. Of the 30 patients, 18 (60%) had renal contusions, 7 (23%) had minor lacerations, 4 (13%) had major lacerations and one had vascular injury. One patient had penetrating trauma and the other 29 had blunt trauma. Two patients (7%) had pre-existing renal anomalies. Associated injuries were present in 16 patients (53%). The presence of associated injuries had no relation to the severity of the renal injury. Computerized tomography (CT) with contrast medium was more sensitive to abnormal findings, especially subcapsular and perirenal hematoma, than excretory pyelography. Findings of renal angiography provided additional anatomical information for deciding immediate surgical treatment and for selecting operative methods for salvage of the kidney.(ABSTRACT TRUNCATED AT 250 WORDS)