病例报告:外表可能会欺骗:急性术后渐进性功能障碍和高血症没有显著的水缩
Reza Lahiji1, Ahmet Yildirim2, William Luke1
1Department of Urology, Emory University School of Medicine, Atlanta, GA, United States.
Frontiers in oncology
|February 16, 2026
概括
延迟发作的水缩可以在没有早期成像症状的情况下发生,特别是在单独的脏中. 早期临床衰退需要怀疑阻塞,以防止不可逆转的损伤.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 水性是尿路阻塞的常见症状,通常在7天内出现.
- 然而,这个时间表不是绝对的,在某些临床情景中可能会延迟.
研究的目的:
- 在患有转移性细胞癌 (RCC) 的患者中报告一种罕见的延迟发作的水性缩病例.
- 要突出成像在尿路阻塞早期诊断的局限性.
主要方法:
- 一个59岁的男性患有转移性RCC,接受了彻底切除术的案例介绍.
- 使用了手术前成像,手术后功能监测 (eGFR),血清水平,重复成像和核医学研究.
- 干预包括nephrostomy管的放置.
主要成果:
- 患者经过切除术后出现了快速功能下降,尽管最初的轻度水性缩和维持了基线EGFR.
- 衰退8天后重复成像显示没有显著的水缩,延迟了诊断.
- 核医学证实了孤独中的延迟输液和阻塞生理学.
- 瘤管的放置导致了功能的快速改善.
结论:
- 在成像中缺少水缩并不能排除尿路阻塞,特别是在单独的脏中.
- 过敏阻塞可能会导致快速的内压力稳定,延迟放射性水.
- 高风险患者的早期临床恶化需要高阻塞怀疑指数和进一步评估.
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