Wu Bo-Sheng, Ho Yang, Yang Chih-Yu
Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan.
Clin Exp Nephrol. 2020 Oct;24(10):971-972. doi: 10.1007/s10157-020-01915-7. Epub 2020 Jun 26.
We report a 71-year-old woman who presented with unilateral flank pain and sepsis. A computed tomographic (CT) scan demonstrated left-sided hydronephrosis. Subsequent percutaneous nephrotomy drainage showed pus-like material, confirming the diagnosis of pyonephrosis. The ureteral stricture was caused by previous radiation injury for cervical cancer in this ESRD patient who was on chronic dialysis for years. In our case, the grade IVB hydronephrosis is a result of an extremely atrophic kidney, pyonephrosis, and ureteral stricture. The CT section of pyonephrosis in an extremely atrophic kidney resembles a sagittal section of a Nautilus shell, as the shell corresponds to the diffusely thinned renal cortex.
我们报告了一名71岁的女性，她出现了单侧胁腹疼痛和脓毒症。计算机断层扫描（CT）显示左侧肾盂积水。随后的经皮肾造瘘引流显示出脓性物质，证实了脓性肾盂积水的诊断。在这名接受了多年慢性透析的终末期肾病（ESRD）患者中，输尿管狭窄是由先前宫颈癌放疗损伤所致。在我们的病例中，IVB级肾盂积水是极度萎缩的肾脏、脓性肾盂积水和输尿管狭窄共同导致的结果。极度萎缩肾脏中脓性肾盂积水的CT断面类似于鹦鹉螺壳的矢状断面，因为该壳对应于弥漫变薄的肾皮质。
