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腹股沟疝合并膀胱,导致对侧同种异体移植肾积水——病例报告及文献综述

Inguinal Herniation Containing Bladder, Causing Contralateral Allograft Hydroureteronephrosis-A Case Report and Literature Review.

作者信息

du Toit T, Kaestner L, Muller E, Kahn D

机构信息

Division of Transplant Surgery, Groote Schuur Hospital, Cape Town, South Africa.

Division of Urology, Groote Schuur Hospital, Cape Town, South Africa.

出版信息

Am J Transplant. 2017 Feb;17(2):565-568. doi: 10.1111/ajt.14052. Epub 2016 Oct 27.

Abstract

We report the first documented case of an inguinal hernia containing bladder, resulting in contralateral allograft hydroureteronephrosis. A 39-year-old male patient presented with allograft dysfunction, a contralateral inguinoscrotal hernia, and marked hydroureteronephrosis on ultrasound (US). Percutaneous nephrostogram and a retrograde cystogram suggested bladder herniation with incorporation of the contralateral ureteroneocystostomy into the hernia. Paraperitoneal bladder herniation was confirmed at surgery and hernioplasty was performed. Six-week follow-up revealed normal renal function with no sign of hernia recurrence. Despite occurring rarely, transplant ureter or bladder herniation should be considered in the differential diagnosis of hydroureteronephrosis. This case illustrates that the contralateral position of hernia to allograft does not necessarily preclude the hernia as the source of ureteric obstruction.

摘要

我们报告了首例有文献记载的腹股沟疝包含膀胱的病例,该病例导致对侧同种异体移植肾积水性输尿管肾病。一名39岁男性患者出现同种异体移植功能障碍、对侧腹股沟阴囊疝,超声检查显示明显的积水性输尿管肾病。经皮肾造影片和逆行膀胱造影提示膀胱疝形成,对侧输尿管膀胱吻合口被纳入疝内。手术证实为腹膜旁膀胱疝,并进行了疝修补术。六周随访显示肾功能正常,无疝复发迹象。尽管移植输尿管或膀胱疝很少见,但在鉴别诊断积水性输尿管肾病时应考虑到。本病例表明,疝与同种异体移植的对侧位置并不一定排除疝是输尿管梗阻的原因。

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