Gleeson N C, Parsons A K, Hoffman M S, Cavanagh D
Department of Obstetrics and Gynecology, University of South Florida, H. Lee Moffitt Cancer Center, Tampa.
Obstet Gynecol. 1993 Oct;82(4 Pt 2 Suppl):644-6.
The majority of ureteric injuries associated with an operation are the result of gynecologic surgery. Thus, gynecologists must be aware of this risk and appreciate that ureteric injury can present late and in an unusual manner.
A 26-year-old woman presented with gross abdominal distention 4 months after total abdominal hysterectomy. Ultrasonography demonstrated a large volume of ascitic fluid and a complex cyst arising from the left ovary. Serum blood urea nitrogen and creatinine were normal. Laparotomy showed a mass of 1-2-cm cysts (urinomas) on the pelvic peritoneum and tubo-ovarian surfaces and a right hydroureter with a right ureteric fistula at the level of the ureteric tunnel. A ureteroneocystostomy was performed.
Ureteroperitoneal fistula with urinary ascites is a rare complication of pelvic surgery. Intravenous urography or computed tomography scan would have helped establish the diagnosis.
大多数与手术相关的输尿管损伤是妇科手术的结果。因此，妇科医生必须意识到这种风险，并认识到输尿管损伤可能出现较晚且方式不寻常。
一名26岁女性在全腹子宫切除术后4个月出现腹部明显膨隆。超声检查显示大量腹水以及左卵巢出现一个复杂囊肿。血清血尿素氮和肌酐正常。剖腹探查显示盆腔腹膜和输卵管卵巢表面有1至2厘米大小的囊肿（尿瘤）团块，右侧输尿管积水，在输尿管隧道水平处有右侧输尿管瘘。进行了输尿管膀胱吻合术。
输尿管腹膜瘘合并尿性腹水是盆腔手术的一种罕见并发症。静脉尿路造影或计算机断层扫描有助于确诊。
