Berrocal A, Quezada F, Cruces de Abia F, López de Alda A, Vela Navarrete R
Arch Esp Urol. 1989 Jul-Aug;42(6):587-91.
We report a case of spontaneous rupture of the ureter from an impacted calculus, paradigm of diagnostic and therapeutic difficulties of these uncommon pathologic conditions. Spontaneous rupture of the ureter from an impacted calculus should be considered in cases of persistent renal colic and atypical presentation. Diagnosis is based on urographic evidence of urinary extravasation. This should be differentiated from nephric colic from urinary extravasation arising from the renal fornices which is relatively common in nephric colic. Treatment must always include drainage of the urinoma, ureteroraphy, and urinary diversion. However, a controversy exists on the advantages and disadvantages of nephrostomy versus ureteral splinting.
我们报告一例因结石嵌顿导致输尿管自发性破裂的病例,此类罕见病理状况存在诊断和治疗难题。对于持续肾绞痛且表现不典型的病例,应考虑结石嵌顿导致输尿管自发性破裂的可能性。诊断基于尿路造影显示的尿外渗证据。这应与肾绞痛时相对常见的源于肾穹窿的尿外渗引起的肾绞痛相鉴别。治疗必须始终包括尿囊肿引流、输尿管修复术和尿流改道。然而,关于肾造瘘术与输尿管支架置入术的利弊存在争议。