Nassiri Nima, Maas Marissa, Asanad Kian, Hwang Darryl, Duddalwar Vinay, Bhanvadia Sumeet
Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
Urol Case Rep. 2020 May 4;32:101220. doi: 10.1016/j.eucr.2020.101220. eCollection 2020 Sep.
An 82 year-old female presents with severe, sharp right-sided chest, shoulder and flank pain, worse with deep inspiration. Cardiac workup is negative for myocardial ischemia or aortic dissection. Computed tomography demonstrates a right posterior diaphragmatic (Bochdalek) hernia, involving the right extra-renal pelvis and proximal ureter, with an associated delayed nephrogram and mild hydronephrosis. There is no obstructing nephrolithiasis. The patient is taken to the operating room and right-sided double-J ureteral stent is placed (Fig. 1), with immediate resolution of pain. Diaphragmatic hernia repair in coordination with urology and general surgery is scheduled.
一名82岁女性因严重的右侧胸部、肩部和侧腹剧痛前来就诊，深呼吸时疼痛加剧。心脏检查排除心肌缺血或主动脉夹层。计算机断层扫描显示右侧后膈（博赫达勒克）疝，累及右肾外肾盂和近端输尿管，伴有延迟性肾图和轻度肾积水。无梗阻性肾结石。患者被送往手术室，置入右侧双J输尿管支架（图1），疼痛立即缓解。计划与泌尿外科和普通外科协作进行膈疝修补术。
