腎外傷の診断について

Abstract

腎外傷25例のIVPおよびCT像について検討した.25例の腎外傷の程度をIVPで分類すると, 腎挫傷13例, 腎裂傷11例, 腎断裂1例であった.25例中, CT scanも施行した14例について検討した結果, CT scanは腎外傷の程度, とくに腎周囲血腫の診断に有用であった.腎周囲血腫はCT scanで7例に明らかに認められたが, IVPでは, 腎輪郭と腸腰筋の不鮮明が腎周囲血腫の存在を示唆するものと考えられた.腎周囲血腫はすべて保存的治療で吸収されたが, 7例中5例は3ヵ月以内であった

We experienced 25 cases of renal trauma in our hospitals during the past 5 years, 20 cases were male and 5 cases were female, ranging in age 10 to 51 years old with average 26 years old, and the chief complaints were gross-hematuria and pain of renal region. We studied the IVP and CT patterns of these cases. IVP revealed 13 cases of renal contusion, 11 cases of renal lacerated wound and 1 case of renal fragmentation. The CT scan of 14 cases showed that it was useful for the diagnosis of the degree of renal trauma, especially, for hematoma surroundings the kidneys. The hematoma surrounding the kidneys was clearly noted in 7 cases by CT scan, but the unclearness of renal contours and iliopsoas muscle was considered to suggest the existence of hematoma surrounding the kidneys by IVP. All of the hematoma surrounding the kidneys was absorbed by conservative therapy, but 5 of the 7 cases were treated within 3 months.