Maillet P J, Laville M, Pelle-Francoz D, Traeger J, Pinet A
Presse Med. 1985 Oct 5;14(33):1733-7.
Four patients with no evidence of acute functional or organic renal failure suddenly developed anuria. Repeated ultrasonographic exploration failed to show any dilatation of the urinary tract. After 4, 5, 7 and 34 days of anuria respectively, an obstacle was detected, located and identified by ultrasonically guided antegrade pyelography, which led to immediate urine derivation by percutaneous nephrostomy. Three of these patients were cured by percutaneous techniques alone. These 4 cases represent a small but not negligible part of a series of 74 patients with obstructive anuria, 70 of whom had dilated renal cavities. They throw doubt not on the reliability of ultrasonography, but on the idea that all obstacles are associated with dilatation upstream. They also confirm that opacification of the urinary tract is the only way of making sure that an obstacle is present. Antegrade pyelography gives excellent contrast images and can be used as first stage of a percutaneous nephrostomy. The other diagnostic methods are fraught with a high proportion of inadequacy or failure.
4例无急性功能性或器质性肾衰竭证据的患者突然出现无尿。反复超声检查未发现尿路扩张。分别在无尿4天、5天、7天和34天后，通过超声引导下顺行肾盂造影检测到梗阻部位，并对其进行定位和识别，随后立即通过经皮肾造瘘术进行尿液引流。其中3例患者仅通过经皮技术治愈。这4例患者占74例梗阻性无尿患者的一小部分，但并非可以忽略不计，74例患者中有70例肾腔扩张。这些病例并非质疑超声检查的可靠性，而是质疑所有梗阻都伴有上游扩张的观点。它们还证实，尿路显影是确定存在梗阻的唯一方法。顺行肾盂造影可提供出色的对比图像，可作为经皮肾造瘘术的第一阶段。其他诊断方法存在较高比例的不充分或失败情况。
