Naidich J B, Rackson M E, Mossey R T, Stein H L
Radiology. 1986 Sep;160(3):653-7. doi: 10.1148/radiology.160.3.3526404.
Ureteral obstruction can lead to renal failure without involving detectable dilatation of the calyces, renal pelvis, or ureter proximal to the obstruction. This phenomenon was noted in seven patients who had clinical obstruction that we were not able to diagnose using computed tomography (CT) or ultrasonography (US). These patients underwent percutaneous nephrostomy (PCN), which resulted in brisk diuresis and improved renal function. We obtained an accompanying antegrade urogram in these cases, which demonstrated the level of obstruction and indicated that dilatation of the collecting system was minimal or not present. When obstructive uropathy is suspected, we believe it is essential to consider performing PCN to evaluate and potentially reverse renal failure, even when CT and US scanning do not demonstrate obstruction.
输尿管梗阻可导致肾衰竭，而不伴有肾盂、肾盏或梗阻近端输尿管的可检测到的扩张。在7例临床存在梗阻但我们无法通过计算机断层扫描（CT）或超声检查（US）诊断的患者中发现了这种现象。这些患者接受了经皮肾造瘘术（PCN），术后出现大量利尿且肾功能改善。在这些病例中，我们同时获得了顺行性尿路造影，其显示了梗阻部位，并表明集合系统的扩张程度最小或不存在。当怀疑存在梗阻性肾病时，我们认为即使CT和US扫描未显示梗阻，考虑进行PCN以评估并可能逆转肾衰竭也是至关重要的。
