Chopra Prajna, Cleveland Curtis H, Johnson Mark, Michell Hans, Holoch Peter, Irwin Brian, Scriver Geoffrey M, Morris Christopher S
University of Vermont College of Medicine, Burlington, VT, USA.
Interventional Radiology, Department of Radiology, University of Vermont Medical Center, 111 Colchester Ave., Burlington, VT 05401, USA.
Radiol Case Rep. 2020 Jun 1;15(8):1121-1127. doi: 10.1016/j.radcr.2020.04.038. eCollection 2020 Aug.
An excluded calyx is a rare, acquired urologic condition where there is discontinuity between a portion of the renal collecting system with the remainder of the collecting system. Re-establishment of reliable long-term communication between the excluded calyx and the remaining collecting system is crucial for preservation of renal function and possible relief of symptoms. In this manuscript, we discuss two such cases where a previously undescribed novel procedure is used for treatment of this uncommon condition, where percutaneous antegrade transcatheter techniques were used to establish long-term urinary drainage. The first case discusses an excluded calyx in a 17-year-old male who suffered left renal injury after a high speed motor vehicle accident, where the kidney was divided by the injury and subsequently required creation of a neoinfundibulum in order to maintain continuity of the collecting system. The second case involves a 39-year-old female who underwent resection of a renal cell carcinoma, later developing an excluded calyx where radiofrequency wire recanalization was performed and the neoinfundibular track underwent serial retrograde balloon dilation, resulting in a continuous collecting system. Both patients have done well for more than 2 years after neoinfundibulum creation, showing that this novel technique should be considered a viable and safe procedure in the treatment of this rare condition.
孤立肾盏是一种罕见的后天性泌尿系统疾病，即肾集合系统的一部分与集合系统的其余部分之间存在连续性中断。在孤立肾盏与其余集合系统之间重建可靠的长期连通对于保留肾功能和缓解症状至关重要。在本论文中，我们讨论了两例这样的病例，其中使用了一种此前未描述过的新方法来治疗这种罕见疾病，即采用经皮顺行导管技术来建立长期尿液引流。第一例讨论的是一名17岁男性的孤立肾盏，他在高速机动车事故后左肾受伤，肾脏因损伤而被分隔，随后需要创建一个新肾盂以维持集合系统的连续性。第二例涉及一名39岁女性，她接受了肾细胞癌切除术，后来出现孤立肾盏，对其进行了射频导线再通术，并对新肾盂通道进行了系列逆行球囊扩张，从而形成了连续的集合系统。两例患者在创建新肾盂后均已良好生存超过2年，这表明这种新技术应被视为治疗这种罕见疾病的一种可行且安全的方法。
