renal artery occlusion
Introduction
Introduction to renal artery occlusion Although renal artery occlusion is rare, occlusion is the most common disease affecting the renal artery. Often due to embolism or atherosclerosis caused by a wall thrombus (atrial arrhythmia, previous myocardial infarction, neoplasms of bacterial endocarditis). Often due to embolism or atherectomy due to ventricular wall thrombosis (atrial arrhythmia, previous myocardial infarction, bacterial endocarditis), less common cause of fat or tumor embolism basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: interstitial nephritis
Cause
Cause of renal artery occlusion
Often due to embolism or atherosclerosis caused by wall thrombosis (atrial arrhythmia, previous myocardial infarction, bacterial endocarditis), less common cause of fat or tumor embolism, renal artery thrombosis Formation of vascular trauma secondary to atherosclerosis (surgery, angiography, angioplasty) or intimal tear or renal aneurysm rupture, acute segmentation of the renal artery (another cause of occlusion) Less common than the aorta, but more than any other peripheral arteries, the original arteriosclerosis disease or fibrous dysplasia often form spontaneous or traumatic segmentation, but angioplasty has become a common cause.
Prevention
Renal artery occlusion prevention
Diet does not affect the occurrence of this disease (such as lack of nutrition, drinking spleen and kidney loss), diet should be light, avoid spicy, cold, to the source of absolute sputum, in the remission period, medicated diet usually to benefit Lung, spleen, kidney-based, should not eat squid, shrimp, crab, raw chicken and other "hair", acute infection period, diet should be light and rich in nutrition, should be spicy, hot and dry, diet therapy should be combined with the treatment .
Complication
Renal artery occlusion complications Complications interstitial nephritis
The most common complication is subrenal hematoma and necrosis of the kidney.
Symptom
Renal artery occlusion symptoms Common symptoms Kidney area sputum pain into the small arteriolar glassy kidney area tenderness aorta blood supply disorder hematuria left and right abdominal pain
The definitive diagnosis of renal artery occlusion usually relies on renal angiography, but the intravenous contrast agent spiral CT is equally sensitive and specific. The renal blood flow is reduced in radionuclide renal angiography, or the blood flow is lacking on the side of severe thromboembolic disease. For example, although renal angiography is non-invasive, it is not satisfactory for the image quality of the surgical purpose. Double Doppler ultrasonography is also sensitive and specific, but it is time consuming and highly dependent on the operator's professional skills. The value of magnetic resonance is not Affirmation, atrial fibrillation, recent history of myocardial infarction or trauma or past embolic episodes; symptoms and signs, complete lack of excretory function on the affected side and normal collecting system are strong evidence of renal obstruction, impaired excretion due to ureteral obstruction Other tests, such as ultrasonography or excretory urography.
Examine
Renal artery occlusion examination
Partial occlusion of the renal artery is often asymptomatic and neglected, because segmental infarction or renal ischemia without infarction, this occlusion can lead to persistent hypertension, when renal infarction is suspected, extra-osseous embolism signs (such as skin damage, bureau Defects in focal neuropathy should be looked up carefully.
When completely occluded, persistent painful hypochondriac pain and local tenderness may occur, which may have fever, nausea and vomiting. Complete occlusion of an isolated renal side renal artery or bilateral renal arteries may result in complete anuria and acute renal failure. In this case, hypertension is not common or temporary.
Diagnosis
Diagnosis and diagnosis of renal artery occlusion
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Differential diagnosis
1. Acute appendicitis: right renal artery occlusion occurs in the right side of the waist, abdominal pain should be differentiated from high appendicitis, the latter with right lower abdomen pain, localized tenderness and abdominal muscle tension as clinical features; without hematuria and renal pelvis Pain; blood, urine alkaline phosphatase and lactate dehydrogenase did not increase.
2. Ureteral calculi: paroxysmal colic and hematuria, but hematuria is aggravated at the onset of pain or activity; stone shadows can be seen in the urinary tract plane; ureteral catheter insertion is obstructed by retrograde pyelography; the radionuclide kidney diagram is obstructive.
3. Waist, abdominal mass: cystic mass may occur when renal insufficiency secondary to subrenal hematoma, and need to be differentiated from renal parenchymal tumor, renal cyst, perirenal cyst, renal malformation, hydronephrosis, adrenal tumor.
