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输尿管闭孔疝病例报告及文献复习分析。

Case report of ureter obturator hernia and literature review analysis.

机构信息

Department of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China.

Department of General Surgery, The First Affiliated Hospital of Xiamen niversity, Xiamen, 361001, China.

出版信息

BMC Urol. 2021 May 29;21(1):86. doi: 10.1186/s12894-021-00851-2.

Abstract

BACKGROUND

Ureteral obturator hernia is a rare condition, usually found accidentally during imaging examinations, or found during surgery. Ureteral hernia can easily lead to ureteral obstruction and hydronephrosis. Long-term hydronephrosis may lead to kidney damage and infection, and eventually cause kidney failure. As of December 31, 2020, there are only 2 literature reports.

CASE PRESENTATION

This article reports a 67-year-old female patient with no symptoms. The computed tomography (CT) scan of the urinary system to show the left kidney and ureter had hydrops. The CTU imaging of the urinary tract revealed the left ureter pelvis herniated into the parietal pelvic fascia was accompanied by tortuosity and left hydronephrosis. She underwent laparoscopic abdominal wall hernia repair on April 29, 2020, and she recovered well.

CONCLUSIONS

Ureteral obturator hernia is an uncommon condition. The clinical symptoms are non-specific, including unclear abdominal pain, until the appearance of obstructive diseases of the urinary tract, such as renal insufficiency, urinary tract infection, kidney stones, and uremia. A comprehensive review of the literature shows that it is difficult to make an accurate diagnosis based on physical examination alone.Early urography can improve the possibility of accurate diagnosis. When a patient suffers from impaired renal function, timely surgical treatment can avoid deterioration of renal function.

摘要

背景

输尿管闭孔疝是一种罕见的疾病,通常在影像学检查中偶然发现,或在手术中发现。输尿管疝容易导致输尿管梗阻和肾积水。长期肾积水可能导致肾损伤和感染,最终导致肾衰竭。截至 2020 年 12 月 31 日,仅有 2 篇文献报道。

病例介绍

本文报告了一位 67 岁女性患者,无明显症状。泌尿系统计算机断层扫描(CT)显示左肾和输尿管积水。尿路 CTU 成像显示左侧输尿管骨盆疝入壁盆腔筋膜,伴有迂曲和左侧肾积水。她于 2020 年 4 月 29 日接受腹腔镜腹壁疝修补术,术后恢复良好。

结论

输尿管闭孔疝是一种不常见的疾病。临床表现无特异性,包括不明确的腹痛,直到出现尿路梗阻性疾病,如肾功能不全、尿路感染、肾结石和尿毒症。对文献的全面回顾表明,仅通过体格检查很难做出准确的诊断。早期尿路造影可提高准确诊断的可能性。当患者出现肾功能受损时,及时的手术治疗可避免肾功能恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6358/8164797/ecfa9cc7619b/12894_2021_851_Fig1_HTML.jpg

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