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患者,男,32岁。右上腹包块2年,尿急、尿频、尿痛10天。体检:右肾区饱满,右上腹可触及一肿块,约14×14cm,质中度,表面光滑,无压痛,活动度差。腹部平片示右侧输尿管中段一阳性结石影,约3.0×1.0×1.0cm。B超示右肾失去正常形态,约19.4×13.9×14.2cm。IVP60分钟右肾不显影,左肾盂、盏形态正常。经腹入路探查,右肾明显增大,右肾盂及上段输尿管扩张。于髂血管下2.0cm处输尿管内可触及一硬性肿块。纵行切开此段输尿管见有约2.5×0.8×0.8cm结石一枚,其表面光滑,质坚硬。结石中
Patient, male, 32 years old. Right upper quadrant mass 2 years, urgency, frequent urination, dysuria 10 days. Physical examination: the right kidney area full, the right upper quadrant can reach a mass, about 14 × 14cm, moderate quality, smooth surface, no tenderness, poor activity. Abdominal plain film showed a right side of the ureter a positive shadow of stones, about 3.0 × 1.0 × 1.0cm. B ultrasound showed that the right kidney loses its normal morphology, about 19.4 × 13.9 × 14.2cm. IVP60 minutes right kidney does not develop, left renal pelvis, lamp form normal. Proximal approach exploration, the right kidney was significantly increased, the right renal pelvis and upper ureteral dilatation. 2.0cm at the iliac artery ureter can reach a hard mass. Longitudinal incision ureter see this section about 2.5 × 0.8 × 0.8cm stones, the surface smooth, hard quality. In the stone