Acquired Ureteral Diverticulum: A Case Report

輸尿管憩室是一種非常少見的疾病，她可分為先天性和後天性。本文報告：八十二歲女姓為一偶然發現後天性輸尿管憩室病例。病人因為排尿困難，氮血症及尿路感染就醫，理學檢查發現病人虛弱，膀胱尿儲留，插入輸尿管導管解除膀目光出口阻塞現象。住院後病情持續改善，影像檢查發現右腎積水，右輸尿管阻塞及右輸尿管憩室。手術切除輸尿管憩室，手術發現憩室周圍輸尿管，腹膜，及血管沾粘嚴重，整塊切除，輸尿管端端吻合，並插入雙J導管。病理報告發現線頭性肉芽腫及憩室部份沒有肌肉層。因此證明該憩室為後天性。雙J導管三週後拔除，三個月後超音波檢查發現腎積水已不明顯。

關鍵字

輸尿管憩室；逆行性腎盂攝影；前行性腎盂攝影；輸尿管輸尿管吻合術；雙J導管

並列摘要

Ureteral diverticulum is a very rare disease and may be classified into congenital and acquired types. This report describes the case of an 82 year old female admitted to the hospital due to symptoms of dysuria, azotemia and urinary tract infection. Physical examination and history taking revealed general weakness , bladder distension and repeated attack of urinary tract infections. An indwelling catheter was then inserted for relief of urethral obstruction. The patient s general condition gradually improved and stabilized after insertion of the catheter and antibiotic administration. Renal echogram showed severe right hydronephrosis, and retrograde and antegrade pyelograms revealed that the right lower ureter was obstructed by a narrowing lesion and had a dilated diverticulum. An extra-peritoneal approach was made in the right lower abdomen for excision of the ureteral diverticulum. Segmental resection and end to end uretero-ureterostomy were performed and a 7Fr-26cm Double-J tube was inserted. Pathological findings included stitch s granuloma and normal transitional mucosa lining ,however , no muscle layer was contained in the diverticulum. Thus, diverticulum was of the acquired type. The Double-J tube was removed 3 weeks later. Three months later, renal echogram showed a dramatic decrease in the degree of hydronephrosis .

並列關鍵字

ureteral diverticulum ； retrograde pyelogram ； antegrade pyelogram ； uretero-ureterostomy ； double-J tube

國際替代計量

Acquired Ureteral Diverticulum: A Case Report

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