Résumé
Objective To investigate the cause and treatment experience for traumatic renal subcapsular hematoma.MethodsThe data of eleven cases with traumatic renal subcapsular hematoma were reviewed.four cases were caused by external injury,and seven cases were iatrogenic,including four cases of postESWL patients,two cases of post-ureteroscopic lithotripsy patients and one case after percutaneous renal biopsy.The patients were treated with conservative treatment,percutaneous drainage of the hematoma and surgical exploration,respectively.Results Four cases received conservative treatment,six cases received percutaneous drainage of the hematoma,and one case received surgical exploration.Seven of the ten cases who received conservative treatment or percutaneous drainage of the hematoma were continuously followed up for 1 to 3 years.They recovered well without complications such as renal hypertension,renal function impairment,hydronephrosis and renocortical pyogenic infection.One case was performed nephrectomy due to severe trauma and hemorrhage during the surgical exploration.ConclusionTraumatic renal subcapsular hematoma usually occurs after flank abdomen injury,iatrogenic injury such as ESWL,ureteroscopic lithotripsy and percutaneous renal biopsy.CT and ultrasound examination are the major means to diagnose traumatic renal subcapsular hematoma and determine the severity.Optimistic prognosis can be obtained after conservative treatment and percutaneous drainage of the hematoma.Surgical exploration should be avoided as far as possible.
Résumé
Objective To probe the most effective method for the diagnosis of early renal pelvic cancer. Methods Ultrasound, introvenus urogram (IVU), retrograde pyelography, CT, magnetic resonance urography and transurethral ureteropeyloscopy were performed, and the accuracy rate was evaluated. Results The accuracy rate of IVU, retrograde pyelography, CT, transurethral ureteropeyloscopy, MRU and ultrasound were 89%, 94%, 80%, 50%, 40% and 22% respectively. Conclusions IVU and retrograde pyelography are the common and necessary diagnostic methods for early renal pelvic cancer. Transurethral ureteropeyloscopy is an invasive method and used as a final method when other methods fail to identify the disease.