[A serious complication after bladder embolisation due to massive tissue necrosis in the gluteal region]. / Eine schwerwiegende Komplikation in Form massiver Gewebenekrosen in der glutealen Region nach Embolisation der Harnblase.
Aktuelle Urol
; 45(1): 50-3, 2014 Jan.
Article
en De
| MEDLINE
| ID: mdl-24500962
ABSTRACT
Adequate and successful treatment of Hb-relevant macrohaematuria in bladder cancer patients is a frequent problem in clinical routine. It is often not easy to identify a good treatment option for inoperable older patients. A possible option is transcatheter-based arterial embolisation of the vesical artery. Unfortunately there are only few publications about this procedure; a detailed analysis of bladder embolisation is difficult to find in the literature. Our report illustrates the embolisation of the vesical artery in an 84-year-old patient with bladder cancer with an Hb-relevant, transurethral non-curable macrohaematuria. Massive necrosis of the M. gluteus maximus developed after embolisation of the vesical artery. During the ensuing surgery, the entire musculature of the gluteal region was removed, and the N. ischiadicus was cut. The patient was supervised first in the intensive care and then in the palliative care ward. The patient's prognosis is unfavourable due to the localisation and size of the wound and consecutive life-long immobility. Embolisation of the vesical artery is a viable procedure, but only if alternative therapeutic strategies are impossible. It should only be performed by an experienced radiologist and it is strongly recommended not to apply liquid embolisation agents. Inadequate embolisation of the vesical artery can lead to extensive necrosis. Radiological diagnostics help to identify the margins of the necrotic region. During the intervention, maximum attention should be paid to saving the entirety of N. ischiadicus, especially in patients with large necrotic areas.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vejiga Urinaria
/
Neoplasias de la Vejiga Urinaria
/
Nalgas
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Carcinoma Papilar
/
Embolización Terapéutica
/
Hematuria
Tipo de estudio:
Prognostic_studies
Límite:
Aged80
/
Female
/
Humans
/
Male
Idioma:
De
Revista:
Aktuelle Urol
Año:
2014
Tipo del documento:
Article