Abstract:
Spontaneous suburothelial hemorrhage is a rare process of unclear pathologic etiology, although it has been associated with bleeding diathesis and anticoagulation. The most common clinical presentation is acute onset flank pain and macroscopic hematuria. On imaging, there is a mural thickening of the renal pelvis and upper ureters leading to luminal narrowing. Despite luminal narrowing, hydronephrosis has only rarely been reported in the association. The imaging finding of mural thickening has led to the misdiagnosis as malignancy, resulting in unnecessary nephrectomy. Suburothelial hemorrhage can be unilateral or bilateral, although the majority of reported cases are unilateral. We present a case of a patient with bilateral spontaneous suburothelial hemorrhage with forniceal rupture and spontaneous retroperitoneal hemorrhage, a unique triad compared to prior cases presented in the literature.
摘要:
自发性上皮下出血是一个罕见的过程,其病理病因不明确,尽管它与出血素质和抗凝有关。最常见的临床表现是急性发作的侧腹疼痛和肉眼可见的血尿。在成像方面,肾盂和上输尿管壁层增厚导致管腔狭窄。尽管管腔狭窄,在该协会中很少报道肾积水。影像学发现的壁增厚导致误诊为恶性肿瘤,导致不必要的肾切除术。上皮下出血可为单侧或双侧,尽管大多数报告的病例是单方面的。我们介绍了一例双侧自发性上皮下出血伴穹窿破裂和自发性腹膜后出血的患者,与文献中提出的先前案例相比,这是一个独特的三合会。