Rosenblatt Gregory S, Takesita Ken, Fuchs Gerhard J
Minimally Invasive Urology Institute, Cedars-Sinai Medical Center, Los Angeles, CA.
Can Urol Assoc J. 2009 Dec;3(6):E77-80. doi: 10.5489/cuaj.1185.
The primary presentation of congenital megaureter in adults is rare. Development of urolithiasis may lead to this unusual underlying diagnosis. Urinary tract stones can form either within the dilated ureteral segment or in a part of the upper urinary tract proximal to the abnormal ureteral segment. We report two cases of nephrolithiasis that occurred in adults found to have segmental megaureter. The first case is that of a 58-year-old man who presented with left lower quadrant pain. Computed tomography scan revealed a 2-cm stone in the distal left ureter within an area of isolated segmental distal ureteral dilation. The second case is a 48-year-old man who developed recurrent renal urolithiasis associated with isolated distal megaureter.Although a rare condition in adults, congenital megaureter may present when kidney stones develop as a result of the ureteral abnormality. Typically, stones will develop within the dilated segment of ureter. Atypically, stones may develop away from the site of the underlying abnormality. Congenital megaureter is a diagnosis that urologists and radiologists need to consider in the setting of isolated distal ureteral dilation, as the diagnosis of adult megaureter may require more involved surgical measures to prevent recurrence of adverse symptoms.
先天性巨输尿管在成人中的主要表现较为罕见。尿路结石的形成可能导致这种不寻常的潜在诊断。尿路结石可在扩张的输尿管段内形成，也可在上尿路中异常输尿管段近端的部分形成。我们报告两例成人肾结石病例，这些患者被发现患有节段性巨输尿管。第一例是一名58岁男性，表现为左下腹疼痛。计算机断层扫描显示左输尿管远端有一个2厘米的结石，位于孤立性节段性远端输尿管扩张区域内。第二例是一名48岁男性，患有与孤立性远端巨输尿管相关的复发性肾结石。尽管先天性巨输尿管在成人中是一种罕见疾病，但当肾结石因输尿管异常而形成时，可能会出现。通常，结石会在输尿管的扩张段内形成。非典型情况下，结石可能在远离潜在异常部位处形成。先天性巨输尿管是泌尿科医生和放射科医生在孤立性远端输尿管扩张情况下需要考虑的诊断，因为成人巨输尿管的诊断可能需要更复杂的手术措施来预防不良症状的复发。
