Endoscopic Management of a Ureteral Obstruction Caused by Endometriosis: A Case Report

以內視鏡處理子宮內膜異位造成的輸尿管阻塞－病例報告

阮序承(Hsu-Cheng Juan) ； 葉信志(Hsin-Chih Yeh) ； 蕭錫麟(His-Lin Hsiao) ； 楊曉芳(Shean-Fang Yang) ； 吳文正(Wen-Jeng Wu)

《The Kaohsiung Journal of Medical Sciences》 25卷4期 (2009/04) Pp. 217-221

摘要

因子宮內膜異位症造成輸尿管阻塞是不常見的。本篇文章，我們報告一位49歲女性經由健康檢查中的腹部超音波檢查意外發現右側腎積水。以輸尿管鏡做檢查及切片，病理組織診斷為輸尿管子宮內膜異位。一個月後，至婦產科做子宮全切除及雙側卵巢、輸卵管切除手術。目前門診追蹤病患，雖然有殘存腎水腫，但肌酸酐由已原先2.0 mg/dL降至1.2 mg/dL。

關鍵字

子宮內膜異位 ； 腎水腫 ； 輸尿管 ； 輸尿管鏡

並列摘要

Ureteral obstruction secondary to endometriosis is relatively uncommon. We present a 49-year-old female (gravida 3, para 2, abortion 1), who was identified as suffering from right hydronephrosis while undergoing her regular health examination. Retrograde pyelography demonstrated a partial obstruction of the right ureter in the distal third. She underwent ureteroscopy and biopsy to remove a right ureteral tumor. Histological examination confirmed ureteral endometriosis. During follow-up at the obstetrics and gynecology outpatient department, an abdominal echo was detected that revealed a right endometrioma (size, 7.5×4.8×5.5 cm) on the ovary. As a result, a total hysterectomy and bilateral salpingo-oophorectomy was performed. Although the patient had right residual hydronephrosis, the creatinine level improved to 1.2 mg/dL during follow-up.

並列關鍵字

endometriosis ； hydronephrosis ； ureter ； ureteroscopy