Janin P, Haillot O, Vannier J, Berton C, Lanson Y
Service d'Urologie, Hôpital Bretonneau, Tours.
J Urol (Paris). 1990;96(7):381-5.
One case of right ureteral stenosis due to a flow of necrosis from an acute lithiasic pancreatitis, treated with the insertion of a double J tube, is reported. 14 cases of ureteral stenosis following pancreatitis have been found in the literature. They occur whatever the severity of pancreatitis and can either reveal it or, on the contrary, be asymptomatic. The ureteral lesions are of three kinds: compression by a pseudocyst of the pancreas, sheathing of the ureter and "ureteritis" in the flows of necrosis, necrosis of the ureteral wall. The management of these ureteral stenoses involves treating both the pancreatitis and the obstruction, according to its type. In cases of compression or sheathing of the ureter, ureteral endoprostheses inserted in an early stage allow maintaining the patency of the ureter during the healing phase. In case of ureteral necrosis, nephrostomy, then ureteral resection prove to be necessary.
本文报道了1例因急性结石性胰腺炎坏死物流出导致右输尿管狭窄的病例，该病例通过插入双J管进行治疗。文献中已发现14例胰腺炎后输尿管狭窄的病例。无论胰腺炎的严重程度如何，这些狭窄均可发生，它们既可能是胰腺炎的表现，也可能相反，没有症状。输尿管病变有三种类型：胰腺假性囊肿压迫、输尿管包绕以及坏死物流中的“输尿管炎”、输尿管壁坏死。这些输尿管狭窄的治疗包括根据狭窄类型同时治疗胰腺炎和梗阻。在输尿管受压或被包绕的情况下，早期插入输尿管内支架可在愈合阶段保持输尿管通畅。在输尿管坏死的情况下，肾造瘘术，然后输尿管切除术被证明是必要的。
