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一例左髂外动脉后外侧巨大输尿管合并额外肾脏及血管先天性异常病例。

A Case of Left Retroexternal Iliac Artery Megaureter Associated with Additional Renal and Vascular Congenital Anomalies.

作者信息

Karadaghy Amin A, Bell Matthew T, Daly Daniel T, Tan Yun

机构信息

Center for Anatomical Science and Education, Department of Surgery, Saint Louis University School of Medicine, Saint Louis, MO 63104, USA.

出版信息

Case Rep Urol. 2020 Jul 24;2020:8946435. doi: 10.1155/2020/8946435. eCollection 2020.

Abstract

. A number of rare anatomical anomalies, including retroexternal iliac ureter, extrarenal calyces (ERCs), and vascular anomalies, were observed in a 96-year-old female cadaver during a routine dissection. . A markedly dilated left extrarenal pelvis (ERP) with a diameter of 3.15 cm was noticed. Three major calyces were found outside of the normal-sized left kidney. The abdominal aorta (AA), instead of normal bifurcation, branched to the right common, left external, and left internal iliac arteries. The median sacral artery was a direct branch from the right common iliac artery. No hydronephrosis was observed on the affected side, and no urinary tract anomalies were observed on the right side. . The retroiliac megaureter is a rare congenital anomaly, with fewer than 25 cases reported to date. Additionally, the ERCs are amongst the rarest anomalies of the renal collecting system. Further, the current case is one of few reported cases where the particular branching pattern of the AA was observed. The combination of such anatomical anomalies is rare, and the relationship between them is unclear. Common clinical manifestations of retroiliac ureters are the results of ureteric obstruction, hydronephrosis, and secondary infection. Precise knowledge of anomalies of the kidney and urinary tract can help radiologists and surgeons make a definitive diagnosis and prevent inadvertent injury during surgery.

摘要

在对一名96岁女性尸体进行常规解剖时,观察到一些罕见的解剖学异常情况,包括髂外后输尿管、肾外肾盂(ERC)和血管异常。发现左侧肾外肾盂(ERP)明显扩张,直径为3.15厘米。在正常大小的左肾外发现了三个主要肾盂。腹主动脉(AA)未正常分叉,而是分支为右总髂动脉、左外髂动脉和左内髂动脉。骶中动脉是右总髂动脉的直接分支。患侧未观察到肾积水,右侧未观察到尿路异常。髂后巨输尿管是一种罕见的先天性异常,迄今为止报道的病例少于25例。此外,ERC是肾集合系统中最罕见的异常之一。此外,本病例是少数报告观察到AA特定分支模式的病例之一。这种解剖学异常的组合很少见,它们之间的关系尚不清楚。髂后输尿管的常见临床表现是输尿管梗阻、肾积水和继发感染的结果。对肾脏和尿路异常的精确了解有助于放射科医生和外科医生做出明确诊断,并防止手术期间的意外损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/855f/7396064/50bfb025aee2/CRIU2020-8946435.001.jpg

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