Progressive Deterioration of Renal Function Caused by Ureteropelvic Junction Obstruction and Contralateral Iatrogenic Ureteral Injury

先天性腎盂輸尿管連接處狹窄及對側人為輸尿管傷害所引起之進行性腎功能喪失－病例報告

陳黎明(Lia-Beng Tan) ； 嚴孟意(Meng-Yin Yan) ； 康介乙(Chieh-Yi Kang) ； 黃偉晃(Wei-Hwang Huang) ； 陳俊宏(Jiuan-Horng Chen)

《中華民國泌尿科醫學會雜誌》 3卷2期 (1992/06) Pp. 795-798

https://doi.org/10.7024/JUAROC.199206.0795

摘要

患者為八歲男性孩童，六個星期前因小腸憩室在外面醫院接受小腸部分切除術，術後患者之尿量逐漸減少，至住院前一天因抽筋及無尿現象而轉到本院接受進一步治療，患者之尿素氣(BUN)高達 72mg/dl，酐肌酸(CRTN)高達8.5mg/dl，在二側輸尿管完全阻塞之診斷下患者先接受左側經皮腎穿刺術及右側皮膚做腎盂輸尿管攝影結果證實為左側先天性腎盂輸尿管狹窄及右側人為輸尿管傷害。患者之尿素氣及酐肌酸皆恢復正常後接受左側Anderson-Hynes腎盂成形術及右側部分輸尿管切除及輸尿管輸尿管吻合術，術後四個月患者之尿素氣為1.0mg/dl兒靜注腎盂攝影也顯示腎功能恢復正常。

並列摘要

A 8-year-old boy was undergone jejunal diverticulectomy due jejunal diverticuli-tis at another hospital six weeks previously. The postoperative course was complicated by progressive oliguria. He was transfer to our emergency room with convulsion and anuria for 24 hours. The invesgations showed a blood urea nitrogen of 72 mg/dl. The treatment was started with left percutaneous nephrostomy. The antegrade pyelography demonstrated left ureteropelvis junctional obstruction and complete obstruction of right ureter. Left Anderson-Hynes pyeloplasty with right partial ureterectomy and ureter-oureterostomy were carried out after reanl function had became normal. Four months postoperatively the renal function was normal and the excretory urogram demonstrated patency of bilateral collecting system.