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成人先天性巨输尿管伴附加肾少见报道,本人报告1例如下。 患者,男性,30岁。因左腰部隐痛不适3月,于1996年6月12日入院。查体:左肾区叩痛阳性。KUB及静脉肾盂造影提示:左肾重度积水,左肾阳性结石,左下巨输尿管;逆行造影提示:左侧巨大输尿管,直径为3.0cm,膀胱入口处呈鸟嘴样改变,左侧重肾,呈Y形开口于左侧输尿管上段。手术时所见:左输尿管中下段扩张约3.0cm。处理:将输尿管扩张段裁剪成形,裁剪后输尿管口径为0.7cm,用隧道法膀胱输尿管再植,支架管引流重肾。病理检查:输尿管粘膜被覆移行上皮,层次各异,粘膜下层不甚明显,内环外纵肌肥厚。术后肾功能正常出院。 讨论:Coulk在1923年首先描述巨输尿管,而附
Adult congenital giant ureter with attached kidney rarely reported, I report the following one. Patient, male, 30 years old. Due to pain in the left lumbar discomfort in March, was admitted on June 12, 1996. Physical examination: the left kidney area knocking pain positive. KUB and intravenous pyelography prompted: left kidney severe hydronephrosis, left kidney-positive stones, the left lower giant ureter; retrograde angiography prompted: the left huge ureter, a diameter of 3.0cm, the bladder entrance was beak-like changes in the left kidney, Y-shaped opening in the left upper ureter. Surgical findings: the middle and lower left ureteral dilatation about 3.0cm. Treatment: The ureteral dilatation segment is cut and shaped, the diameter of the ureter after cutting is 0.7cm, and the tunnel urethral ureter replantation is performed. The stent is drained to weigh the kidneys. Pathological examination: ureter mucosa transitional epithelium, different levels, the submucosa is not obvious, the inner longitudinal muscle hypertrophy. Postoperative renal function was normal discharge. Discussion: Coulk first described the giant ureter in 1923, and attached