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[输尿管坐骨疝的输尿管支架置入治疗]

[URETEROSCIATIC HERNIA TREATED BY URETERAL STENT PLACEMENT].

作者信息

Maeda Koki, Arai Yutaka, Nishida Masanari, Sato Wataru, Kageyama Susumu, Narita Mitsuhiro, Kawauchi Akihiro

机构信息

The Department of Urology, Kusatsu General Hospital.

(Present affiliation: The Department of Urology, Nagahama Red Cross Hospital).

出版信息

Nihon Hinyokika Gakkai Zasshi. 2019;110(2):144-147. doi: 10.5980/jpnjurol.110.144.

Abstract

Ureterosciatic hernia is an uncommon condition that can cause ureteral obstruction. Here, we report a case of ureterosciatic hernia successfully treated by ureteral stent placement. A 95-year old woman presented to our emergency department with high fever. An abdominal CT scan revealed mild left hydronephrosis and urinalysis identified pyuria. The patient was subsequently admitted to hospital with a diagnosis of complicated pyelonephritis. No recovery was evident after antimicrobial treatment, a repeat CT scan revealed a ureterosciatic hernia. We indwelled a left ureteral stent and repaired the hernia. We did not opt for a surgical approach because of the patient's age and presence of dementia. The stent was removed after 2 months, but the patient was re-admitted 4 months later because of pyelonephritis. Here, we indwelled a left ureteral stent, and the patient underwent regular ureteral stent exchange. Placement of a ureteral stent for ureterosciatic hernia is an effective treatment for elderly patients and those who are poor surgical candidates.

摘要

坐骨输尿管疝是一种罕见的可导致输尿管梗阻的病症。在此,我们报告一例通过放置输尿管支架成功治疗的坐骨输尿管疝病例。一名95岁女性因高热就诊于我院急诊科。腹部CT扫描显示左肾轻度积水,尿液分析发现脓尿。该患者随后因复杂性肾盂肾炎入院。抗菌治疗后未见明显恢复,再次CT扫描发现坐骨输尿管疝。我们留置了左输尿管支架并修补了疝。由于患者年龄和痴呆症的存在,我们未选择手术方法。2个月后取出支架,但患者在4个月后因肾盂肾炎再次入院。在此,我们再次留置了左输尿管支架,患者接受了定期输尿管支架更换。对于老年患者和手术条件较差的患者,放置输尿管支架治疗坐骨输尿管疝是一种有效的治疗方法。

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