자연 발생한 요관파열 1례
A Case of Spontaneous Ureteral Rupture
소속 상세정보
구자현/Ja Hyeon Ku
임용순/김영호/전윤수/이남규/Yong Soon Yim/Young Ho Kim/Yun Soo Jeon/Nam Kyu Lee
KMID : 0358319990400050649
Abstract
서론
요관의 자연파열은 매우 드물게 발생하는 비뇨기과의 응급질환의 하나이다. 이 질환은 비
특이적 급성 복증(acute abdomen)과 증상을 감별하기 힘들고, 매우 드물게 발생하므로 진단
이 어렵고 적절한 치료가 지연될 수 있다 따라서 심각한 합병증을 유발할 수 있으므로 정확
한 진단과 신속한 치료가 중요하다.
저자들은 좌측 측복부 동통을 주소로 내원한 65세 남자환자에서 발생한 요관 자연파열 1
례를 치험하였기에 문헌고찰과 함께 보고한다.
We report a case of spontaneous uretreral rupture cured by conservative management.
The patient(65-year-old man) who had left flank pain for 6 days was presented to our
hospital. He had no history of trauma and previous urologic problems. Diagnosis was
made by IVP and abdominal CT scan, which showed extravasation from left upper
ureter and accumulation of a large amount of contrast media in the retroperitoneal space.
On ureteroscopy, partial obstruction of left lower ureter was found and the upper
ureteral mucosa showed diffuse erythematous changes. The rupture site with
erythematous edema and some necrotic tissues was identified in lateral wall near
ureteropelvic junction. A guide wire was passed upward the rupture site under direct
vision of ureteroscope and then 6 Fr. double J stent was successfully palced. The stunt
was removed 4 weeks after the placement. Followup IVP showed good urinary
drainange without evidence of extravasation.
키워드
Spontaneous rupture; Ureter;
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