Narayan Prabhat, Salimi Zahra, Salimi Fatemeh
Department of Urology, Oxford University Hospital, Oxford.
Department of Urology, St James University Hospital, Leeds, UK.
Ann Med Surg (Lond). 2023 Feb 7;85(2):178-180. doi: 10.1097/MS9.0000000000000080. eCollection 2023 Feb.
We discuss the case of a 67-year-old man who presented with a right-sided abdominal pain and on subsequent radiological imaging(s) in the form of an enhanced computed tomography scan of the abdomen and pelvis followed by a delayed excretory phase (computed tomography urogram), found to have a distal 4 mm vesicoureteric junction stone which had caused a pelvicoureteric junction rupture which was evident on extravasation of contrast. This warranted an urgent surgical intervention in the form of ureteric stent insertion. This case clearly depicts that with even a small stone associated with severe flank pain, rupture or pelvicoureteric junction/calyces should be suspected and we should never overlook symptoms and push for medical expulsive therapy in patients who do not appear to be septic or obstructed. This work has been reported in line with the Surgical CAse REport (SCARE) criteria.
我们讨论了一名67岁男性的病例，该患者出现右侧腹痛，随后进行了腹部和骨盆增强计算机断层扫描以及延迟排泄期（计算机断层扫描尿路造影）等影像学检查，发现其膀胱输尿管连接部远端有一枚4毫米结石，该结石导致了肾盂输尿管连接部破裂，造影剂外渗时这一点很明显。这需要通过插入输尿管支架进行紧急手术干预。该病例清楚地表明，即使是与严重侧腹痛相关的小结石，也应怀疑有肾盂输尿管连接部/肾盏破裂，对于看起来没有感染或梗阻的患者，我们绝不能忽视症状而一味推行药物排石治疗。本病例报告符合外科病例报告（SCARE）标准。
