Douroumis Konstantinos, Katsikatsos Panagiotis, Kotrotsios Konstantinos, Moulavasilis Napoleon, Fragkiadis Evangelos, Stravodimos Konstantinos, Mitropoulos Dionysios
First Department of Urology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC.
Cureus. 2024 Jul 15;16(7):e64597. doi: 10.7759/cureus.64597. eCollection 2024 Jul.
Hydrocalyx is the obstruction of a renal calyx resulting from infundibulopelvic stenosis or diminution and can be congenital or acquired. A 37-year-old man with a history of preemptive kidney transplantation in 2007 and transplant rejection underwent another ABO-incompatible transplant. During follow-up four months after transplantation, a transplant biopsy was performed, which revealed acute thrombotic microangiopathy. Seven months after transplantation, the patient was admitted to the hospital because of elevated creatinine levels and dilatation of the upper calyx on ultrasound examination. Upper calyx hydrocalycosis and calyceal neck stenosis were diagnosed. Nephrostomy placement along with an antegrade double-J stent through the upper major calyceal neck was performed. Endoscopic dilatation of the narrowed neck of the upper major calyx 10 days after hydrocalyx decompression was performed without intraoperative or postoperative complications. During follow-up, the patient was asymptomatic, had steady creatinine levels, and showed no signs of obstruction on ultrasound. This case highlights that treatment with balloon dilation of the calyceal neck appears to be an effective solution that respects the renal parenchyma and function.
肾盂积水是由肾盂漏斗部狭窄或变窄导致的肾盏梗阻，可为先天性或后天性。一名37岁男性，有2007年肾移植先发制治疗及移植排斥反应病史，接受了另一次ABO血型不相容移植。移植后4个月随访期间，进行了移植肾活检，结果显示为急性血栓性微血管病。移植后7个月，患者因肌酐水平升高及超声检查发现上肾盏扩张而入院。诊断为上肾盏积水和肾盏颈部狭窄。行经上大肾盏颈部的肾造瘘术并置入顺行双J支架。肾盂积水减压10天后，对上大肾盏狭窄颈部进行内镜扩张，术中及术后均无并发症。随访期间，患者无症状，肌酐水平稳定，超声检查无梗阻迹象。该病例突出表明，对肾盏颈部进行球囊扩张治疗似乎是一种有效的解决方案，且能保护肾实质和肾功能。
