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病例报告:具有盲端的双歧输尿管:腹腔镜手术治疗。

Case Report of Bifid Ureter with a Blind Ending: Surgical Laparoscopic Management.

机构信息

Department of Urology, Hospital Center De L'ardenne, Libramont, Belgium.

出版信息

Am J Case Rep. 2022 Aug 7;23:e936311. doi: 10.12659/AJCR.936311.

Abstract

BACKGROUND The blind-ending branch of a bifid ureter is a rare congenital anomaly which is usually asymptomatic but can occasionally give rise to various symptoms, such as chronic abdominal pain. Diagnosis is most often confirmed radiologically, and treatment is usually conservative. Surgical resection of the blind ending of a bifid ureter should be considered in cases of persistent symptoms. CASE REPORT A female patient of 49 years of age presented with intermittent right lumbar pain, repetitive urinary infections and microscopic hematuria. We present here the diagnostic work-up of the case, leading to the identification of the existence of ureteral bifidity located at the lower third of the ureter and of a blind ending of the bifid ureter. Several regimens of various antibiotics failed to resolve the symptoms. It was decided to carry out a laparoscopic resection of the blind ending of the bifid ureter. We describe the practical procedures of the surgical operation and discuss briefly the embryological etiology and the physiopathology of the condition as well as the principal diagnostic modalities. Since the surgery, the patient has been symptom-free. CONCLUSIONS Despite being usually asymptomatic, the rare congenital anomaly of a bifid ureter with a blind ending can occasionally give rise to symptoms such as recurrent infections and persistent abdominal pain. Laparoscopic-based resection of the blind ending should be considered in such cases.

摘要

背景

双输尿管盲端分支是一种罕见的先天性异常,通常无症状,但偶尔会引起各种症状,如慢性腹痛。诊断通常通过放射学确认,治疗通常是保守的。对于持续性症状,应考虑手术切除双输尿管盲端。

病例报告

一名 49 岁女性患者出现间歇性右侧腰痛、反复尿路感染和镜下血尿。我们在此介绍该病例的诊断过程,确定存在输尿管分叉位于输尿管下三分之一处,以及双输尿管盲端。多种抗生素方案均未能缓解症状。决定进行腹腔镜下双输尿管盲端切除术。我们描述了手术操作的实际步骤,并简要讨论了该疾病的胚胎学病因和病理生理学以及主要的诊断方法。自手术后,患者无症状。

结论

尽管双输尿管盲端分支通常无症状,但偶尔会出现反复感染和持续性腹痛等症状。对于这种情况,应考虑基于腹腔镜的盲端切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52a/9366920/3d09a1d724a0/amjcaserep-23-e936311-g001.jpg

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