Ambiavagar R, Nambiar R
Injury. 1979 Aug;11(1):71-6. doi: 10.1016/s0020-1383(79)80132-1.
Six cases of avulsion injury to the pelvi-ureteric junction due to blunt abdominal trauma are reported. Primary repair was done in three cases and nephrectomy in the rest. The special problems in the diagnosis and treatment are discussed. Pelvi-ureteric junction rupture due to blunt external trauma is a distinct clinical entity. The early diagnosis of the injury is rendered difficult by the paucity of early clinical signs and symptoms. A high index of clinical suspicion and early intravenous pyelography in suspected cases will improve the percentage of cases diagnosed. The treatment of choice is primary repair by ureteropelvic anastomosis. In selected cases where primary anastomosis is not possible procedures such as ureterocalycostomy or the use of an ileal segment may be feasible. As the injury commonly occurs in young children, renal preservation is of paramount importance and nephrectomy should be performed only as a last resort.
报告了6例因钝性腹部创伤导致肾盂输尿管连接处撕脱伤的病例。3例行一期修复，其余行肾切除术。讨论了诊断和治疗中的特殊问题。钝性外力创伤导致的肾盂输尿管连接处破裂是一种独特的临床病症。早期临床体征和症状较少使得损伤的早期诊断变得困难。对疑似病例保持高度的临床怀疑并尽早进行静脉肾盂造影将提高确诊病例的比例。治疗的首选方法是通过输尿管肾盂吻合术进行一期修复。在某些无法进行一期吻合的病例中，诸如输尿管肾盂造口术或使用回肠段等手术可能是可行的。由于这种损伤常见于幼儿，保留肾脏至关重要，肾切除术应仅作为最后的手段进行。
