Gauthier F, Montupet P, Valayer J
Chir Pediatr. 1983;24(1):45-9.
Seven cases of calyceal diverticula were seen from 1967 to 1981 in children aged 2 to 16 years at the moment of diagnosis. Symptoms were: gross hematuria (2 cases), urinary infection (2 cases), recurrent abdominal pain (2 cases) or enuresia. All children had a single diverticulum. Five of the 7 diverticula were located at upper renal pole. One of the children presenting with hematuria and renal colic had an oxalic calculous within diverticulum. Three small diverticula did not require treatment and remained uncomplicated with a follow-up of 14,18 and 60 months. Four complicated diverticula (1 from oxalolithiasis, 1 from hematuria and 2 from urinary infection) required surgical removal, by partial nephrectomy (1 case) or deroofing operation with intradiverticular ligation of the communication channel (3 cases). Results were good in 3 children. Removal of adjacent parenchyma with a residual cavity was necessary 5 years later in the fourth child. The majority of children calyceal diverticula seem to be from congenital origin, but some authors suggest that the y could result from vesico-tubular reflux. The possibility of late complications from small and asymptomatic diverticula has been emphasized by many authors. The deroofing operation is certainly the elective procedure when a large or complicated diverticulum requires surgical treatment.
1967年至1981年间,我们在诊断时发现了7例肾盂憩室患儿,年龄在2至16岁之间。症状包括:肉眼血尿(2例)、泌尿系统感染(2例)、反复腹痛(2例)或遗尿。所有患儿均为单个憩室。7个憩室中有5个位于肾上极。1例出现血尿和肾绞痛的患儿憩室内有草酸钙结石。3个小憩室无需治疗,随访14、18和60个月均无并发症。4个复杂憩室(1例因草酸结石、1例因血尿、2例因泌尿系统感染)需要手术切除,其中1例行部分肾切除术,3例行憩室去顶术并在憩室内结扎交通通道。3例患儿效果良好。第4例患儿5年后因残留腔隙需要切除相邻肾实质。大多数儿童肾盂憩室似乎起源于先天性,但一些作者认为可能是由于膀胱输尿管反流所致。许多作者强调了小的无症状憩室发生晚期并发症的可能性。当大的或复杂的憩室需要手术治疗时,憩室去顶术无疑是首选手术。