PDF(Pubmed)
Abstract：
OBJECTIVE: To emphasize preventive measures and outline management strategies for inadvertent ureteral cannulation.
METHODS: We present a case report and conduct a literature review of 39 case reports on ureteral cannulation, examining a total of 48 patients.
RESULTS: About 67% of the cases were female, and long-term catheterization was observed in 67% of the cases. Neurological conditions such as spinal cord injury (SCI), stroke, dementia, multiple sclerosis, and myasthenia gravis were the primary factors (48%) in ureteral cannulation. Symptoms included flank pain (46%), fever (31%), oliguria (27%), non-deflatable balloon issues (25%), hematuria (21%), abdominal pain (17%), urine leak (12.5%), and nausea/vomiting (8%). Complications varied, including acute pyelonephritis (35%), acute kidney injury (27%), urosepsis (21%), and ureter rupture (17%). Despite inadvertent catheter placement, 25% of patients had no complications. More than half of the patients (58%) were managed through catheter change, while 27% underwent cysto-ureteroscopy with or without balloon puncture or ureteral stenting. Additionally, 10% received interventional radiology procedures, 6.25% underwent surgical repair, and 4% underwent ultrasound-guided balloon puncture.
CONCLUSIONS: Female gender, neurologic conditions, and long-term catheterization were identified as predominant risk factors. Early detection of ureteral cannulation can prevent severe complications, particularly in certain special populations such as patients with neurogenic bladder or SCI, who may have reduced sensation and expression capabilities.
METHODS: We present a case report and conduct a literature review of 39 case reports on ureteral cannulation, examining a total of 48 patients.
RESULTS: About 67% of the cases were female, and long-term catheterization was observed in 67% of the cases. Neurological conditions such as spinal cord injury (SCI), stroke, dementia, multiple sclerosis, and myasthenia gravis were the primary factors (48%) in ureteral cannulation. Symptoms included flank pain (46%), fever (31%), oliguria (27%), non-deflatable balloon issues (25%), hematuria (21%), abdominal pain (17%), urine leak (12.5%), and nausea/vomiting (8%). Complications varied, including acute pyelonephritis (35%), acute kidney injury (27%), urosepsis (21%), and ureter rupture (17%). Despite inadvertent catheter placement, 25% of patients had no complications. More than half of the patients (58%) were managed through catheter change, while 27% underwent cysto-ureteroscopy with or without balloon puncture or ureteral stenting. Additionally, 10% received interventional radiology procedures, 6.25% underwent surgical repair, and 4% underwent ultrasound-guided balloon puncture.
CONCLUSIONS: Female gender, neurologic conditions, and long-term catheterization were identified as predominant risk factors. Early detection of ureteral cannulation can prevent severe complications, particularly in certain special populations such as patients with neurogenic bladder or SCI, who may have reduced sensation and expression capabilities.
摘要：
目的：强调意外输尿管插管的预防措施和概述管理策略。
方法：我们提供一例病例报告，并对39例输尿管插管报告进行文献复习，共检查48例患者。
结果：大约67%的病例是女性，在67％的病例中观察到长期导管插入术。神经系统疾病，如脊髓损伤（SCI），中风,痴呆症,多发性硬化症,重症肌无力是输尿管插管的主要因素（48％）。症状包括侧腹疼痛（46%），发烧（31%），少尿（27%），不可放气的气球问题(25%)，血尿（21%），腹痛（17%），尿漏(12.5%)，恶心/呕吐(8%)。并发症多种多样，包括急性肾盂肾炎（35%），急性肾损伤（27%），尿脓毒症（21%），输尿管破裂（17%）。尽管无意中放置了导管，25%的患者无并发症。超过一半的患者（58％）通过导管更换进行管理，而27%的人接受了膀胱输尿管镜检查，有或没有球囊穿刺或输尿管支架置入。此外,10%接受了介入放射学程序，6.25%接受了手术修复，4%接受了超声引导下的球囊穿刺。
结论：女性性别，神经状况，长期导管插入术被确定为主要危险因素。早期发现输尿管插管可以预防严重的并发症，特别是在某些特殊人群中，例如神经源性膀胱或SCI患者，他们的感觉和表达能力可能降低。
方法：我们提供一例病例报告，并对39例输尿管插管报告进行文献复习，共检查48例患者。
结果：大约67%的病例是女性，在67％的病例中观察到长期导管插入术。神经系统疾病，如脊髓损伤（SCI），中风,痴呆症,多发性硬化症,重症肌无力是输尿管插管的主要因素（48％）。症状包括侧腹疼痛（46%），发烧（31%），少尿（27%），不可放气的气球问题(25%)，血尿（21%），腹痛（17%），尿漏(12.5%)，恶心/呕吐(8%)。并发症多种多样，包括急性肾盂肾炎（35%），急性肾损伤（27%），尿脓毒症（21%），输尿管破裂（17%）。尽管无意中放置了导管，25%的患者无并发症。超过一半的患者（58％）通过导管更换进行管理，而27%的人接受了膀胱输尿管镜检查，有或没有球囊穿刺或输尿管支架置入。此外,10%接受了介入放射学程序，6.25%接受了手术修复，4%接受了超声引导下的球囊穿刺。
结论：女性性别，神经状况，长期导管插入术被确定为主要危险因素。早期发现输尿管插管可以预防严重的并发症，特别是在某些特殊人群中，例如神经源性膀胱或SCI患者，他们的感觉和表达能力可能降低。
