Mali V, Liu B, Prabhakaran K, Loh D
Department of Paediatric Surgery, National University Hospital, Lower Kent Ridge Road, Singapore 119074.
Singapore Med J. 2005 Jan;46(1):28-30.
Since the routine use of antenatal ultrasonography, congenital pelviureteric junction (PUJ) obstruction rarely presents as an incidental diagnosis following renal trauma. Gross haematuria following seemingly trivial trauma should arouse the suspicion of a pre-existing abnormality. We report a 14-year-old girl with previously asymptomatic and undetected PUJ obstruction who first presented with gross haematuria following a trivial fall. The diagnosis was established by an abdominal computed tomography that showed left chronic hydronephrosis, and was subsequently confirmed on a renal isotope scan. Since the pre-existing hydronephrosis has little impact on the recovery from the injury itself, the initial management was non-operative with an aim to conserve the kidney. As standard surgery has a good outcome, once the renal scan confirmed good renal function, a delayed Anderson-Hynes' pyeloplasty was performed following healing of the kidney laceration as seen on ultrasonography.
自从常规使用产前超声检查以来，先天性肾盂输尿管连接处（PUJ）梗阻很少在肾外伤后作为偶然诊断出现。看似轻微创伤后出现肉眼血尿应引起对先前存在异常的怀疑。我们报告一名14岁女孩，她之前无症状且未被检测出患有PUJ梗阻，首次因轻微跌倒后出现肉眼血尿就诊。通过腹部计算机断层扫描诊断为左肾慢性肾盂积水，随后经肾脏同位素扫描确诊。由于先前存在的肾盂积水对损伤本身的恢复影响不大，初始治疗为非手术治疗，目的是保留肾脏。由于标准手术效果良好，一旦肾脏扫描证实肾功能良好，待超声检查显示肾裂伤愈合后，进行延迟性安德森-海恩斯肾盂成形术。
