输尿管腹股沟疝所致慢性梗阻性尿路病：一例报告
Chronic obstructive uropathy due to uretero-inguinal hernia: A case report.
作者信息
Won Andy Chuk Moon, Testa Gerard
机构信息
St George and Sutherland Hospitals, Clinical Teaching Unit, Ground Floor, Research & Education Centre, 4-10 South Street, Kogarah, NSW 2217, Australia.
出版信息
Int J Surg Case Rep. 2012;3(8):379-81. doi: 10.1016/j.ijscr.2012.04.004. Epub 2012 Apr 16.
INTRODUCTION
Inguinal hernia in men is common but uretero-inguinal hernia is very rare.
PRESENTATION OF CASE
A 85-year-old obese man presented with chronic obstructive uropathy with previous renal ultrasound showing bilateral enlarged kidneys and hydronephrosis. The medical history revealed a 3-year history of a noticeable bilateral partial reducible inguinoscrotal herniae associated with urinary symptoms. Progress CT scan showed very large inguinal herniae, which were predominantly fat-containing with the ureters herniated, and both kidneys were displaced inferiorly.
DISCUSSION
Uretero-inguinal hernia in patients with native kidneys is rare, but cases of renal failure secondary to uretero-inguinal hernia have also been reported previously in the literature with two anatomical variations have been reported - paraperitoneal and extraperitoneal types. Endourological and surgical procedures are rarely straight-forward because of tortuosity of the herniated ureter.
CONCLUSION
Although uretero-inguinal hernia is rare, it can be the cause of chronic renal impairment.
引言
男性腹股沟疝很常见，但输尿管腹股沟疝非常罕见。
病例介绍
一名85岁肥胖男性，患有慢性梗阻性尿路病，之前的肾脏超声显示双侧肾脏肿大及肾积水。病史显示有3年明显的双侧部分可复性腹股沟阴囊疝病史，并伴有泌尿系统症状。增强CT扫描显示非常大的腹股沟疝，主要含脂肪组织，输尿管疝入其中，且双肾向下移位。
讨论
有正常肾脏的患者发生输尿管腹股沟疝很罕见，但文献中也曾报道过输尿管腹股沟疝继发肾衰竭的病例，且已报道有两种解剖变异类型——腹膜旁型和腹膜外型。由于疝入的输尿管迂曲，腔内泌尿外科和外科手术很少能顺利进行。
结论
虽然输尿管腹股沟疝罕见，但它可能是慢性肾功能损害的原因。
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