Author/Editor		Bratuš, Dejan; Hlebič, Gregor
Title		Izolirana strelna poškodba sečevoda - prikaz primera
Translated title		Isolated gunshot ureteral injury - case report
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 4
Publication year		2004
Volume		str. 293-4
Language		slo
Abstract		Background. In the article a case report of an eleven years old child who suffered an air rifle gunshot injury of his right ureter is presented. Methods. The child was admitted to the hospital without any subjective complaints while both ultrasound and CT scan showed a metallic alien body just below the hilus of his right kidney with no surrounding liquid collection. After the condition of the child had worsened with right lumbar and abdominal pain, the control CT scan showed a huge urinoma in his right retroperitoneum. Results. During a surgical exploration an ureteral injury was found with the pellet lying inside the right ureter just below the injury, causing an obstruction of the ureter. After the removal o f the pellet and suturing of the ureter over a double J stent the child recovered without any sequels. Conclusions. The ureter is the least often injured genitourinary organ. The management of these injuries is usually straight forward and is primarily a problem of recognition at the initial presentation, especially of a patient with multiple injuries. The delayed presentation is principally responsible for the morbidity that is associated with a ureteral injury.
Summary		Izhodišča. Prikazan je primer 12-letnega otroka, ki je utrpel strelno poškodbo desnega sečevoda s strelom iz zračne puške. Metode. Ob sprejemu v bolnišnico je bil otrok klinično brez subjektivnih težav, ultrazvočuo (UZ) in računalniško tomografsko (CT) slikanje pokažeta kovinski tujek tik pod hilusom desne ledvice brez kolekcije tekočine v okolici. Šele ob poslabšanju klinične slike z bolečinami desno ledveno in v trebuhu pokaže kontrolni CT obilno kolekcijo tekočine desno retroperitonealno (urin). Rezultati. Ob operativni eksploraciji ugotovimo, da gre za poškodbo začetnega dela sečevoda, metek zračne puške pa leži tik pod poškodovanim mestom v sečevodu in povzroča njegovo obstrukcijo. Po odstranitvi metka, vstavitvi stenta in zašitju sečevoda otrok okreva brez posledic. Zaključki. Poškodbe sečevoda so med poškodbami sečil in spolovil najredkejše. Po navadi ni problem v zdravljenju teh poškodb, ampak v prepoznavi, saj ostanejo ob prvotni evalvaciji predvsem zaradi številnih pridruženih poškodb neprepoznane. Pozna ugotovitev poškodbe sečevoda je glavni krivec za pridruženo obolevnost, ki jo opazujemo ob poškodbah sečevoda.
Descriptors		URETER URETERAL OBSTRUCTION WOUNDS, GUNSHOT CHILD TOMOGRAPHY, X-RAY COMPUTED STENTS