Kaya Cevdet, Pirincci Necip, Karaman M Ihsan
Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Uskudar, Turkey.
Int Urol Nephrol. 2005;37(4):681-3. doi: 10.1007/s11255-005-6917-8.
The giant hydroureteronephrosis is a rare condition. We report a case of a unilateral giant hydroureteronephrosis in an adult patient presenting as palpable abdominal mass secondary to ureterovesical junction (UPJ) stricture. A 51-year-old man presented with a 2-year history of a palpable abdominal mass. Physical examination revealed a grossly distended abdomen that the upper margin of distension was at the level of the epigastrium and the lower one at the suprapubic region. Abdominal ultrasound and computerized tomography demonstrated a very large cystic mass in the right side of retroperitoneum involving all the space from superiorly right sub-diaphragmatic area to the bladder inferiorly. The patient underwent exploration and a right giant hydroureteronephrosis as involving all the retroperitoneal space crossing midline to the left with a liquid content of approximately 7 l caused by stricture at the ureterovesical junction was seen. The hydronephrotic sac was thin and right nephroureterectomy was performed by opening the sac and draining-off the liquid. The literature was reviewed and the management of giant hydronephrosis was discussed.
巨大型输尿管肾盂积水是一种罕见的病症。我们报告一例成年患者的单侧巨大型输尿管肾盂积水,表现为可触及的腹部肿块,继发于输尿管膀胱连接处(UPJ)狭窄。一名51岁男性,有可触及腹部肿块2年病史。体格检查发现腹部明显膨隆,膨隆上缘位于上腹部水平,下缘位于耻骨上区域。腹部超声和计算机断层扫描显示腹膜后右侧有一个非常大的囊性肿块,占据了从右侧膈下区域至上至膀胱的所有空间。患者接受了探查,发现右侧巨大型输尿管肾盂积水,累及整个腹膜后间隙并越过中线至左侧,因输尿管膀胱连接处狭窄导致液体量约为7升。肾积水囊壁薄,通过打开囊壁排出液体进行了右侧肾输尿管切除术。我们回顾了文献并讨论了巨大型肾积水的治疗。