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一名年轻男性的辛纳综合征:病例报告及文献综述

Zinner Syndrome in a Young Male: A Case Report and Review of the Literature.

作者信息

Kummari Satyanarayana, Ranga Mahipal

机构信息

Radiodiagnosis, All India Institute of Medical Sciences, Nagpur, Nagpur, IND.

Radiodiagnosis, MNR Medical College and Hospital, Sangareddy, IND.

出版信息

Cureus. 2024 Dec 1;16(12):e74909. doi: 10.7759/cureus.74909. eCollection 2024 Dec.

Abstract

Zinner syndrome is an extremely uncommon congenital anomaly of the male urogenital tract. It is attributed to an embryological anomaly that arises in the distal segment of the mesonephric or Wolffian duct. It is the inadequate migration of the ureteric bud that contributes to the failure of differentiation of the metanephric blastema, which ultimately results in ipsilateral renal agenesis and atresia of the ejaculatory duct. This condition is characterized by a triad of unilateral renal agenesis, ipsilateral seminal vesicle cysts, and ipsilateral obstruction of the ejaculatory duct. In this case report, we describe a 19-year-old male patient who arrived at the general medicine outpatient department with a dull, aching pain in his abdomen and pelvis, accompanied by a feeling of fullness in his pelvis. He had no history of dysuria, hematuria, or ejaculatory pain. The ultrasound scan, computed tomography, and magnetic resonance imaging of the abdomen and pelvis revealed the absence of the right kidney and compensatory hypertrophy of the left kidney. Another well-defined oblong cystic lesion was seen involving the right seminal vesicle without any enhancement in the post-contrast study. Following a discussion regarding the condition of the patient and radiological findings with the urology team, a diagnosis of Zinner syndrome was established. This was subsequently communicated to the patient, who was presented with various treatment options. He expressed a preference to manage his present relatively mild symptoms and opted for follow-up evaluations. The current case report is intended to highlight a very rare case of Zinner syndrome. In addition, a short overview of the scientific literature was taken into consideration with regard to the specifics of the developmental defect, the primary symptoms, the imaging features, and the potential treatment options.

摘要

津纳综合征是一种极为罕见的男性泌尿生殖道先天性异常。它归因于中肾管或沃尔夫管远端出现的胚胎学异常。输尿管芽迁移不足导致后肾胚基分化失败,最终导致同侧肾缺如和射精管闭锁。这种情况的特征是单侧肾缺如、同侧精囊囊肿和同侧射精管梗阻三联征。在本病例报告中,我们描述了一名19岁男性患者,他因腹部和骨盆钝痛、隐痛并伴有骨盆胀满感来到普通内科门诊就诊。他没有尿痛、血尿或射精痛病史。腹部和骨盆的超声扫描、计算机断层扫描和磁共振成像显示右肾缺如,左肾代偿性肥大。另一个边界清晰的椭圆形囊性病变累及右精囊,造影后检查无强化。在与泌尿外科团队讨论了患者病情和影像学检查结果后,确诊为津纳综合征。随后将这一诊断告知患者,并向他介绍了各种治疗方案。他表示倾向于处理目前相对较轻的症状,并选择了随访评估。本病例报告旨在突出一例非常罕见的津纳综合征病例。此外,还结合科学文献对发育缺陷的细节、主要症状、影像学特征和潜在治疗方案进行了简要概述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b352/11687404/1345252f7262/cureus-0016-00000074909-i01.jpg

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