Ureteropelvic Obstruction Caused by Pancreatitis after Chemotherapy for pediatric Acute Lymphoblastic Leukemia

急性小兒淋巴性血癌化療後之胰臟炎所致腎盂輸尿管阻塞：一個案報告

鄭積慧(Chi-Hui Cheng) ； 李宗龍(Tsung-Lung Lee) ； 曹永魁(Yong-Kwei Tsau)

《Acta Nephrologica》 17卷2期 (2003/05) Pp. 85-89

摘要

因急、慢性胰臟炎所導致的輸尿管阻塞是相當少見的，尤其是在小孩從未有報告過。此個案報告為一11歲男孩因急性淋巴性白血病經化療併發急性胰臟炎，進而導致腎盂輸尿管交接處阻塞。經氣球撐開術及經皮腎臟引流術後，其因阻塞而造成的水腎及輸尿管阻塞獲得改善。本文也對文獻上曾經報告過的類似大人案例共17例、其臨床特徵和處理方法作一整理及討論，我們相信在治療胰臟炎時、一些放射影像上的檢查例如腹部電腦斷層或是腎臟超音波檢查，將能夠幫助對這類罕見的併發症提供及早的診斷進而適當的治療。

關鍵字

天門冬醯胺酶 ； 胰臟炎 ； 電腦斷層 ； 輸尿管阻塞 ； 水腎

並列摘要

Ureteral obstruction has rarely been reported as the complication of acute or chronic pancreatitis and has not previously been reported in pediatric patients. We describe an 11-year-old boy with ureteropelvic obstruction secondary to pancreatitis following chemotherapy for acute lymphoblastic leukemia. The ureteral obstruction and associated hydronephrosis resolved after percutaneous nephrostomy and balloon dilatation of the stenotic ureter. The clinical characteristics and approach to treatment of the 17 adult patients previously reported in literature are also discussed. We believe radiographic imaging, such as abdominal computed tomography or renal ultrasonography during the treatment for pancreatitis, can facilitate the early diagnosis of this rare complication.

並列關鍵字

L-asparaginase ； Pancreatitis ； Computed tomography ； Ureteral obstruction ； Hydronephrosis