Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
Division of Ultrasound, Kindai University Hospital, Osaka-Sayama, Japan.
Clin J Gastroenterol. 2020 Aug;13(4):621-625. doi: 10.1007/s12328-020-01110-x. Epub 2020 Feb 28.
Nephroptosis is a benign disorder defined as a significant descent of the affected kidney as the patient moves from supine to erect. Patients with nephroptosis sometimes manifest symptoms including abdominal pain, back pain, nausea and hematuria, while the majority of those are asymptomatic. Downward migration of the affected kidney induced by a postural change from the supine to the upright position underlies the pathophysiology of nephroptosis. The diagnosis of nephroptosis is difficult since routine imaging examinations are conducted in the supine position alone. Here, we report a case presenting recurrent abdominal pain due to unknown causes. This patient was successfully diagnosed as nephroptosis by ultrasonography and drip infusion pyelography, both of which were performed in both supine and upright positions. This case report strongly suggests that we need to take into consideration a possibility of nephroptosis when we encounter with patients complaining abdominal and/or back pain due to unknown causes.
肾下垂是一种良性疾病,定义为患者从仰卧位变为直立位时,受影响的肾脏明显下降。肾下垂患者有时表现出症状,包括腹痛、背痛、恶心和血尿,而大多数患者则无症状。由仰卧位变为直立位引起的受影响肾脏向下迁移是肾下垂的病理生理学基础。由于常规影像学检查仅在仰卧位进行,因此肾下垂的诊断较为困难。在这里,我们报告了一例因不明原因反复腹痛的病例。该患者通过超声和滴注肾盂造影(均在仰卧位和直立位进行)成功诊断为肾下垂。本病例报告强烈提示,当我们遇到因不明原因而出现腹痛和/或背痛的患者时,需要考虑肾下垂的可能性。