Zaffanello Marco, Brugnara Milena, Cecchetto Mariangela, Manfredi Riccardo, Zuffante Michele, Fanos Vassilios
University of Verona, Department of Mother-Child and Biology-Genetics, Piazzale LA Scuro, 10, Verona, 37134, Italy.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.08.2008.0782. Epub 2009 Feb 27.
A congenital type of ureterovesical junction obstruction may be present in the fetus or at any stage during childhood, more commonly associated with urinary tract infections and other secondary causes. We present the case of a 6-year-old boy who suffered from colic and side pain, which was worsening monthly. He suffered from a giant hydroureteronephrosis resulting from idiopathic ureterovesical junction obstruction, with no clinical or laboratory signs of urinary tract infection or other secondary causes of obstruction. Indications for surgery were a decrease in kidney function (<40%) at scintigraphy, severe hydronephrosis (>30 mm), and the coexistence of symptoms (colic pain). After surgery, kidney function returned to almost completely normal. Unexpectedly an obstruction may become symptomatic late in infancy, especially in patients with normal prenatal ultrasound screening and postnatal life, as was the case for our patient in whom the only clinical sign was pain at flank.
先天性输尿管膀胱连接部梗阻可能在胎儿期或儿童期的任何阶段出现,更常与尿路感染及其他继发性病因相关。我们报告一例6岁男孩,他患有绞痛和侧腹痛,且症状每月加重。他因特发性输尿管膀胱连接部梗阻导致巨大肾盂积水,无尿路感染或其他梗阻性继发性病因的临床或实验室征象。手术指征为肾动态显像显示肾功能下降(<40%)、重度肾积水(>30 mm)以及症状(绞痛)并存。术后,肾功能几乎完全恢复正常。出乎意料的是,梗阻可能在婴儿期晚期才出现症状,尤其是在产前超声筛查及出生后生活均正常的患者中,我们的患者就是如此,其唯一的临床症状是胁腹疼痛。