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与性发育障碍和泄殖腔畸形相关的额外肾脏:一例报告

Supernumerary Kidneys Associated with Disorders of Sexual Development and Cloacal Anomaly: A Case Report.

作者信息

Mesfin Telila, Haji Nuri, Seyoume Fikadu, Seyoum Kenbon, Mesfin Eshetu, Erdachew Tsegaye, Ayane Daniel, Badasa Gadisa, Soboka Moisan

机构信息

Department of Medicine, Madda Walabu University Goba General Hospital, Goba, Ethiopia.

Department of Pediatrics, Madda Walabu University Goba General Hospital, Goba, Ethiopia.

出版信息

Int Med Case Rep J. 2023 Mar 23;16:193-199. doi: 10.2147/IMCRJ.S403690. eCollection 2023.

Abstract

INTRODUCTION

The term "disorders of sexual differentiation" refers to a variety of issues that result in the baby's genitalia being underdeveloped or showing characteristics shared by both sexes. Normal sexual development in utero requires a precise and coordinated spatiotemporal sequence of numerous activating and suppressing factors. Inadequate development of the bipotential gonad into an ovary or a testis is one of the most frequent causes of genital ambiguity (partial gonadal dysgenesis). One in every 50,000 babies suffers from cloacal anomalies, which makes it one of the rarest congenital malformations. The supernumerary kidney is an extremely uncommon congenital abnormality with less than 100 cases reported in the literature.

CASE

We present five days old neonate admitted to the neonatal intensive care unit with a complaint of absence of anal orifice. The baby had not passed meconium within 48 hours after delivery, but the families later realized that meconium had been passing through the urethral orifice along with urine. The child was born to a 32-year-old para-four woman who claims to have been amenorrheic for the past nine months but could not recall her last regular period. On physical examination, the abdomen was grossly distended, and there was no anal opening other than just a dimple on the sacrococcygeal area, and the external genitalia appears female on inspection with labia majora well developed and no fusion.

CONCLUSION

Disorder of sexual differentiation is a clinically diverse set of diseases that interferes with the proper differentiation and determination of sex in the embryo and fetus. One in 50,000 live births results in cloacal abnormalities, which are extremely uncommon. Less than 100 examples of the supernumerary kidney have been documented in the literature, making it an exceptionally rare congenital anomaly.

摘要

引言

“性分化障碍”一词指的是导致婴儿生殖器发育不全或呈现两性特征的各种问题。子宫内正常的性发育需要众多激活和抑制因素精确且协调的时空序列。双潜能性腺发育不全形成卵巢或睾丸是生殖器模糊(部分性腺发育不全)最常见的原因之一。每50000名婴儿中就有1名患有泄殖腔异常,这使其成为最罕见的先天性畸形之一。额外肾是一种极其罕见的先天性异常,文献报道的病例不到100例。

病例

我们收治了一名5天大的新生儿,因肛门开口缺失入住新生儿重症监护病房。该婴儿出生后48小时内未排出胎便,但家属后来发现胎便随尿液从尿道口排出。患儿母亲为一名32岁经产妇,称过去9个月闭经,但记不起最后一次正常月经时间。体格检查时,腹部明显膨隆,除骶尾部仅有一个凹痕外无肛门开口,检查时外生殖器外观呈女性,大阴唇发育良好且未融合。

结论

性分化障碍是一组临床多样的疾病,会干扰胚胎和胎儿性别正常的分化和确定。每50000例活产中有1例会出现泄殖腔异常,极为罕见。文献记载的额外肾病例不到100例,是一种极其罕见的先天性畸形。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/650d/10042168/96709e6a48e6/IMCRJ-16-193-g0001.jpg

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