Miyagi T, Nakashima T, Shimamura M
Deparment of Urology, Ishikawa Prefectural Central Hospital.
Hinyokika Kiyo. 1996 Sep;42(9):677-8.
A 9-year-old girl visited our clinic with recurrent high fever as her chief complaint. Her excretory urogram showed only a few dilated upper calyces. Retrograde pyelography revealed ureteropelvic junction stenosis with hydronephrosis, so that the ureteral catheter could not be passed through the ureteropelvic junction. A fold-like filling defect was also seen above the ureteropelvic junction. At operation the ureteropelvic junction was found to be markedly obstructed, and a semilunar valve-like structure was also observed above it. The valve-like structure was seen where the fold-like filling defect appeared on the retrograde pyelogram. En bloc resection of the lower part of the renal pelvis with the valve-like structure and the ureteropelvic junction was performed, followed by dismembered uretero-pyeloplasty. Histologically, the valve-like structure was a transverse mucosal fold with a muscle layer and without adventitia. Many cases of ureteral valves have been reported, but none with valves or valve-like structures within the renal pelvis as in our case.
一名9岁女孩因反复高烧为主诉前来我院就诊。其排泄性尿路造影仅显示少数上肾盏扩张。逆行肾盂造影显示肾盂输尿管连接部狭窄并伴有肾积水，致使输尿管导管无法通过肾盂输尿管连接部。在肾盂输尿管连接部上方还可见一个褶样充盈缺损。手术中发现肾盂输尿管连接部明显梗阻，且在其上方还观察到一个半月瓣样结构。在逆行肾盂造影上出现褶样充盈缺损的部位可见到瓣样结构。将带有瓣样结构的肾盂下部及肾盂输尿管连接部整块切除，随后进行离断性肾盂输尿管成形术。组织学检查显示，瓣样结构为一横向黏膜褶，有肌层但无外膜。已有许多输尿管瓣膜的病例报道，但均无像我们病例中在肾盂内出现瓣膜或瓣样结构的情况。
