Shiraishi K, Yamamoto M, Takai K, Tei Y, Suga A, Aoki A, Ishizu K, Naito K
Department of Urology, Yamaguchi University School of Medicine.
Hinyokika Kiyo. 1998 Oct;44(10):719-23.
We report a case of urolithiasis caused by surgical treatment for Crohn's disease. A 28-year-old woman was referred to our department for further examination of renal stones from the medical department in September, 1995. She suffered from Crohn's disease and had a history of jejuno-ileal resection because of perforation of the ileum in 1988. Radiographs revealed multiple bilateral renal stones, and the urine oxalate concentration was elevated. She was treated with extracorporeal shock wave lithotripsy and the administration of sodium bicarbonate and citrate, but these treatments did not prevent recurrence and enlargement of stones. Renal function was gradually worsened and we performed transurethral lithotomy and percutaneous nephrolithotripsy. The stones were mainly composed of oxalate calcium monohydrate. A renal biopsy was performed at the operation, showing deposition of crystals in almost all renal tubules. Diet therapy (low oxalate and low fat) and the administration of sodium bicarbonate and citrate were performed strictly and recurrence was not recognized 10 months after complete removal of the stones.
我们报告一例因克罗恩病手术治疗引发的尿石症病例。一名28岁女性于1995年9月从内科转至我科,以便对肾结石做进一步检查。她患有克罗恩病,曾于1988年因回肠穿孔接受空肠回肠切除术。X光片显示双侧多发肾结石,尿草酸浓度升高。她接受了体外冲击波碎石术,并服用碳酸氢钠和柠檬酸盐,但这些治疗未能防止结石复发和增大。肾功能逐渐恶化,我们实施了经尿道取石术和经皮肾镜碎石术。结石主要由一水合草酸钙构成。手术时进行了肾活检,结果显示几乎所有肾小管内均有晶体沉积。严格实施了饮食疗法(低草酸和低脂)并服用碳酸氢钠和柠檬酸盐,结石完全清除10个月后未出现复发。