PDF(Pubmed)
Abstract：
Gross hematuria is one of the most common complications in postrenal transplant patients, accounting for 12% of all renal recipients. The management plan in these cases varies depending on different entities, including infection, renal cell carcinoma, chronic graft rejection, kidney calculus, or recurrence of primary disease. On the other hand, vascular malformation like arteriovenous malformation was less likely to be mentioned due to a lack of consensus in the natural history, pathogenesis, and current management. In this article, we report a 62-year-old man presenting with spontaneous hematuria for a week and 2 days of anuria after 3 years of renal transplantation. Abdominal ultrasound and abdominopelvic computed tomography noted an obstruction of the renal pelvis due to blood clots without signs of vascular injuries. An emergency operation was performed to remove blood clots in the renal pelvis, but after that, hematuria was still recurrence. A digital renal graft subtraction angiography (DSA) revealed an arteriovenous malformation (AVM)in the kidney allograft. This lesion was then successfully selective embolized with glue. Given the high accuracy of DSA, our case highlights the potential role of this imaging modality in diagnosing and treating AVM after failure with other modalities.
摘要：
肉眼血尿是肾移植术后患者最常见的并发症之一,占所有肾脏受者的12%。在这些情况下，管理计划因不同的实体而异，包括感染,肾细胞癌，慢性移植物排斥反应，肾结石,或原发疾病复发。另一方面,由于在自然史上缺乏共识，血管畸形如动静脉畸形不太可能被提及，发病机制，和当前的管理。在这篇文章中,我们报道了一例62岁的男性患者,在接受肾移植3年后出现1周2天的自发性血尿.腹部超声和腹肾盂CT检查发现，由于血凝块而导致肾盂阻塞，没有血管损伤的迹象。进行了紧急手术以清除肾盂中的血凝块，但在那之后,血尿仍复发。数字移植肾减影血管造影（DSA）显示同种异体肾脏动静脉畸形（AVM）。然后用胶水成功地选择性栓塞了该病变。鉴于DSA的高精度,我们的病例强调了这种成像方式在诊断和治疗其他方式失败后的AVM中的潜在作用.
