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希腊一名新兵中偶然发现津纳综合征:一种罕见临床实体的病例报告。

Incidental finding of Zinner syndrome in a Greek military recruit: a case report of a rare clinical entity.

机构信息

Department of Urology, 424 General Military Hospital of Thessaloniki, 56429, Thessaloniki, Greece.

Department of Radiology, 424 General Military Hospital of Thessaloniki, 56429, Thessaloniki, Greece.

出版信息

Mil Med Res. 2019 Feb 14;6(1):4. doi: 10.1186/s40779-019-0194-9.

Abstract

BACKGROUND

Zinner syndrome represents a rare congenital malformation of the urinary tract. It comprises a constellation of Wolffian duct anomalies and is almost exclusively encountered as a classic triad of seminal vesicle cysts, ejaculatory duct obstruction and renal agenesis. Patients can be either asymptomatic or symptomatic. Recently, minimally invasive surgical techniques have emerged, superseding traditional surgery for select symptomatic cases. Our case highlights the finding of a rare clinical syndrome that was incidentally detected during a routine mass screening of military recruits in the Greek Armed Forces.

CASE PRESENTATION

Herein, we present a case of a 19-year-old male who reported having a solitary right kidney when examined in a military training center of Northern Greece. No additional clinical information was available; thus, referral to a tertiary urology department for further investigation ensued. Imaging studies, namely, computed tomography and magnetic resonance imaging, revealed left renal aplasia, multiple left seminal vesicle cysts, and ejaculatory duct obstruction. Laboratory values and urinalysis were within normal range. Semen analysis was significant for cryptozoospermia. Our patient remained asymptomatic during the entire hospitalization. Long-term follow-up was recommended. Nevertheless, he declined further investigation and sought treatment in a private practice setting.

CONCLUSIONS

This article aims to present the incidental diagnosis of a rare syndrome in a military setting. Population screening conducted in the armed forces permits the identification of undiagnosed diseases that warrant further investigation. To the best of our knowledge, this was the first report of Zinner syndrome in a military recruit and the second case cited of a Greek patient in the published literature. Regular follow-up is the key to timely intervention in conservatively managed cases.

摘要

背景

Zinner 综合征代表一种罕见的先天性尿路畸形。它由 Wolffian 管异常组成,几乎仅作为精囊囊肿、射精管梗阻和肾发育不全的经典三联征出现。患者可能无症状或有症状。最近,微创外科技术已经出现,取代了传统手术治疗有症状的病例。我们的病例强调了一种罕见临床综合征的发现,该综合征是在希腊武装部队对新兵进行常规大规模筛查时偶然发现的。

病例介绍

在此,我们介绍了一名 19 岁男性的病例,他在希腊北部的一个军事训练中心体检时报告自己只有一个右侧肾脏。没有其他临床信息,因此转诊到三级泌尿科进行进一步检查。影像学研究,即计算机断层扫描和磁共振成像,显示左侧肾发育不全、多个左侧精囊囊肿和射精管梗阻。实验室值和尿液分析均在正常范围内。精液分析显示严重少精子症。我们的患者在整个住院期间均无症状。建议进行长期随访。然而,他拒绝了进一步的检查,并在私人诊所寻求治疗。

结论

本文旨在介绍在军事环境中偶然诊断出一种罕见综合征。在武装部队进行的人群筛查可发现需要进一步调查的未确诊疾病。据我们所知,这是首例在军事新兵中发现 Zinner 综合征的报告,也是在已发表文献中第二例希腊患者的病例。定期随访是保守治疗病例及时干预的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f70/6375168/ec972b4eef1f/40779_2019_194_Fig1_HTML.jpg

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