A rare case of spontaneous parenchymal kidney explosion in a patient with ureteral obstruction caused by a single stone.

Autor:	Chiancone F; Department of Urology, Antonio Cardarelli Hospital, Naples, Italy., Meccariello C; Department of Urology, Antonio Cardarelli Hospital, Naples, Italy., Ferraiuolo M; Department of Anesthesiology, TIPO e OTI, Antonio Cardarelli Hospital, Naples, Italy., De Marco GP; Emergency Department-Acceptance, TIGU, Antonio Cardarelli Hospital, Naples, Italy., Fedelini M; Department of Urology, Antonio Cardarelli Hospital, Naples, Italy., Langella NA; Department of Urology, Antonio Cardarelli Hospital, Naples, Italy., Fedelini P; Department of Urology, Antonio Cardarelli Hospital, Naples, Italy.
Jazyk:	angličtina
Zdroj:	Urologia [Urologia] 2021 Nov; Vol. 88 (4), pp. 386-388. Date of Electronic Publication: 2020 Nov 27.
DOI:	10.1177/0391560320975881
Abstrakt:	Introduction: Spontaneous rupture of kidney may involve collecting system or parenchyma. Parenchymal rupture usually occurs in patients with renal cell carcinoma, angiomyolipoma, renal cysts, arteriovenous malformation or vascular diseases such as periarteritis nodosa. Collecting system rupture is usually a rare complication of obstructive urolithiasis. We describe the unusual cases of spontaneous kidney rupture in patients with acute urinary obstruction. Case Presentation: The case report describes the left parenchymal kidney explosion related to ipsilateral ureteral obstruction caused by a single ureteral stone. The patient reached our emergency department with acute left flank pain and massive haematuria. At the moment of admission, the patient was in stage III hypovolemic shock and had a lower haematocrit (haemoglobin = 4.9 g/dL). Despite blood transfusions, emergency surgical exploration, extrafascial nephrectomy and intensive support care, the patient died twelve hours after surgery. Conclusions: Parenchymal renal rupture can be a life-threatening emergency. Despite its rarity, in the differential diagnosis of acute abdomen, parenchymal renal rupture should always be considered in patients with abdominal pain and an anamnesis or history of urinary stones, pointing out the need of early diagnosis also in benign urological conditions.
Databáze:	MEDLINE
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