Viville C, Biechler M, Cinqualbre J
J Urol (Paris). 1983;89(8):533-9.
In the context of urinary tract trauma, closed rupture of the upper urinary tract is rare, although not exceptional. It usually occurs in the region of the pyelo-ureteric junction and more often on the right side. It is more common in children, especially in boys. The diagnosis is often delayed and only made after the appearance of a urinary pseudocyst. The diagnosis depends on intravenous pyelography, ultrasound and retrograde uretero-pyelography, which should only be performed immediately prior to the operation. In the great majority of cases, the urinary tract can be simply repaired by a uretero-ureteral or ureteropyelic anastomosis, or more rarely, a ureterocalyceal anastomosis. The indications for autotransplantation are exceptional and are essentially based on the associated lesions, especially of the renal vascular pedicle. The results are very encouraging; a review of the literature reveals 64 cases of ruptured upper urinary tract whose outcome was able to be followed: 10 nephrectomies (only 3 followed failure of attempted reparative surgery) and 54 salvaged kidneys. Great progress has been made since Bienayme's report in 1962 of 40 cases in which he found only 4 successful repairs.
在上尿路创伤的背景下，上尿路闭合性破裂虽不常见，但并非罕见。它通常发生在肾盂输尿管交界处，且右侧更为多见。在儿童中更为常见，尤其是男孩。诊断往往延迟，通常在出现尿性假囊肿后才得以做出。诊断依赖于静脉肾盂造影、超声和逆行输尿管肾盂造影，这些检查应仅在手术前即刻进行。在绝大多数情况下，尿路可通过输尿管-输尿管吻合术、输尿管肾盂吻合术简单修复，或更罕见地通过输尿管肾盏吻合术修复。自体肾移植的适应证极为罕见，主要基于相关病变，尤其是肾血管蒂的病变。结果非常令人鼓舞；对文献的回顾显示有64例上尿路破裂病例，其结局能够被追踪：10例行肾切除术（其中仅3例是在尝试修复手术失败后进行），54例肾脏得以挽救。自1962年比内梅报告40例病例（他仅发现4例成功修复）以来，已经取得了巨大进展。
