最新:泌尿道感染及损伤(英文版)UT injuries-2h-文档资料.ppt
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1、Introduction,UTI often occurs in male urethra Urinary system are anatomically located in a deep concealed places when the chest, abdomen, flank or back, pelvis have been confronted with violent attack, there may be concomitant urinary system trauma which will need further investigation to establish
2、the diagnosis,Pathological changes,Hemorrhage Extravasation Severe hemorrhage will result in shock. Hematoma and extravasation of urine will complicate with infection Urethral stricture and urinary fistula in late stage,Injuries to the kidney,Pathogenesis and pathology Renal damage can be classified
3、 into open and closed injuries Open injuries are often caused by a sharp instrument as a knife or bullet, making a penetrating wound in the chest or abdomen Closed trauma are usually caused by a direct violent hit on abdomen, loin, or an indirect force by falling from a high place and landing on the
4、 feet or buttocks.,Classification (closed),Contusion: ecchymosis, subcapsular hematoma partial fissure subcapsular hematoma, perirenal hematoma complete fissure extravasation of blood , urine, gross hematuria and shock laceration of renal vascular pedicle,Perirenal hematoma, hematuria and operation
5、to stop bleeding,Late stage changes,urinoma broad fibrosis in post-peritoneal space hydronephrosis renal hypertension,Clinical manifestation,Shock Hematuria Pain Mass Fever,Diagnosis History and physical exam Urine exam X-ray exam, KUB, IVU, CT Ultrasound B,Treatment,Observation Indication for surge
6、ry intractable shock progressing gross hematuria and anemia enlarging abdonimal or loin mass accompanying intra-abdominal or pulmonary damage Selective renal artery embolization Open surgery: repair, partial nephrectomy,nephrectomy,Injury to the bladder,Pathogenesis and pathology Open injury vesicor
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