tailieunhanh - Báo cáo y học: " A review of ureteral injuries after external trauma"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: A review of ureteral injuries after external trauma | Pereira et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 6 http content 18 1 6 SCANDINAVIAN JOURNAL OF t emergency medicine REVIEW Open Access A review of ureteral injuries after external trauma Bruno MT Pereira 1 Michael P Ogilvie1 Juan Carlos Gomez-Rodriguez1 2 Mark L Ryan1 Diego Pena2 Antonio C Marttos1 Louis R Pizano1 Mark G McKenney1 Abstract Introduction Ureteral trauma is rare accounting for less than 1 of all urologic traumas. However a missed ureteral injury can result in significant morbidity and mortality. The purpose of this article is to review the literature since 1961 with the primary objective to present the largest medical literature review to date regarding ureteral trauma. Several anatomic and physiologic considerations are paramount regarding ureteral injuries management. Literature review Eighty-one articles pertaining to traumatic ureteral injuries were reviewed. Data from these studies were compiled and analyzed. The majority of the study population was young males. The proximal ureter was the most frequently injured portion. Associated injuries were present in of patients. Admission urinalysis demonstrated hematuria in only patients. Intravenous ureterogram IVU failed to diagnose ureteral injuries either upon admission or in the operating room in of cases. Ureteroureterostomy with or without indwelling stent was the surgical procedure of choice for both trauma surgeons and urologists 59 . Complications occurred in of cases. The mortality rate was 17 . Conclusion The mechanism for ureteral injuries in adults is more commonly penetrating than blunt. The upper third of the ureter is more often injured than the middle and lower thirds. Associated injuries are frequently present. CT scan and retrograde pyelography accurately identify ureteral injuries when performed together. Ureteroureterostomy with or without indwelling stent is the surgical procedure of choice of both trauma