Ruffolo Cesare, Angriman Imerio, Scarpa Marco, Polese Lino, Barollo Michela, Bertin Matteo, Pagano Duilio, D'Amico Davide Francesco
Department of Surgical and Gastroenterological Sciences, Clinica Chirurgica I, University of Padova, Padova, Italy.
Surg Laparosc Endosc Percutan Tech. 2004 Oct;14(5):292-4. doi: 10.1097/00129689-200410000-00014.
Ureteral involvement due to Crohn's disease occurs in 3% to 6% of cases. Herein, we present a case of a 22-year-old woman with ileocolic Crohn's disease with right hydronephrosis due to compression of the ureter that was resolved with a 3-stage, minimally invasive procedure (preoperative percutaneous nephrostomy, ureteral stent placement, and sequential laparoscopically assisted ileocolectomy). Percutaneous right nephrostomy drainage permitted us to prevent renal damage before surgery, and successive ureteral double-J catheter placement minimized the risk of ureteral damage during the laparoscopic procedure. The safety and feasibility of sequential minimally invasive management of ileocolonic Crohn's disease involving the right ureter was assessed, and a good cosmetic result was achieved.
克罗恩病导致的输尿管受累在3%至6%的病例中出现。在此,我们报告一例22岁女性,患有回结肠型克罗恩病,因输尿管受压导致右肾积水,通过三阶段微创手术(术前经皮肾造瘘、输尿管支架置入及序贯腹腔镜辅助回结肠切除术)得以解决。经皮右肾造瘘引流使我们能够在手术前预防肾损伤,连续放置输尿管双J导管可将腹腔镜手术期间输尿管损伤的风险降至最低。评估了序贯微创治疗累及右输尿管的回结肠型克罗恩病的安全性和可行性,并取得了良好的美容效果。