肾盏憩室1例报告

肾盏憩室20少见病，临床多无特征性表现。我们遇到1例经IVU证实、其排空延迟至12h以上。为增进对本病的认识和了解，现予报告并作简要讨论。     

巨大肾盏憩室一例

肾盏憩室是肾实质内覆盖移行上皮细胞的囊腔,经过狭窄通道与肾盏或肾盂相连通,绝大多数的肾盏憩室无临床症状,但是如果尿液引流不畅,则容易继发感染和结石。肾盏憩室在临床上少见,像本例如此大的肾盏憩室极为少见,现报道如下：     

B超与X线互补对肾盏憩室的诊断

<正> 肾盏憩室为肾囊肿的一种特殊类型,临床发病比较少见。本文采用B超与X线对12例肾盏憩室患者进行对比分析,从中找出它们之间的互补作用。 临床资料 男7例,女5例,年龄25—56岁。症状发生与肾盏憩室的大小有很大关系,较小的一般无临床症状,较大或因憩室内尿潴留而继发感染时可产生轻重不一的症状。本组肾区酸痛6例,血尿4例,膀胱刺激症状5例。在有症状的病例中,3例憩室内伴结石,其余病例未发现其它     

肾盏憩室33例X线诊断分析

肾盏憩室是肾盏附近实质内的囊腔,其内壁与肾盏相同,都被覆上皮细胞,囊腔经-细交通管与肾盏相通.此病比较少见,术前常常误诊.本文综合我院的33例此病患者,其中手术证实13例,有典型X线表现者20例.本文着重讨论X线诊断方面的一些问题.     

肾盂肾盏憩室的X线诊断(附18例分析)

本文对18例肾孟肾盏憩室的好发部位、形态大小、动态功能变化以及憩室继发感染、合并结石和泌尿系畸形等进行了X线征象分析。指出泌尿系造影的典型X线征象是诊断本病的主要方法和依据。同时对本病发病机理、病理基础、肾盂肾盏憩室并发症以及X线诊断与鉴别诊断进行了讨论。     

巨大膀胱憩室的CT诊断

目的:提高对巨大膀胱憩室的认识和CT扫描技术与诊断水平。方法:总结本院1例及国内文献报道10例(共11例)巨大膀胱憩室的CT诊断资料并进行分析。结果:本组11例。CT扫描11例,均诊断为巨大膀胱憩室;B超检查7例,1例误诊为膀胱畸形;静脉肾盂造影(IVP)5例,2例因膀胱显影不良无法判断;膀胱X线造影2例,1例误诊为膀胱畸形;膀胱镜检查6例;手术及病理9例。11例CT检查病例中,合并前列腺增生9例,合并结石4例。结论:CT能较好地显示膀胱憩室的大小、部位、形态、开口及合并症,能为临床提供较准确详细的资料,是诊断膀胱憩室简便有效的办法。     

肾盏憩室误诊为肾囊肿导致术后漏尿的防治探讨（附8例报道）

目的探讨肾盏憩室去顶术后漏尿的治疗方法及预防措施。方法选择2003年至2013年我院收治的8例术后漏尿的患者,术前均误诊为肾囊肿,术后证实为肾盏憩室。在逆行插入D-J管的基础上,1例漏尿自然愈合;7例行手术治疗,其中1例采取微创顺行切开扩大憩室颈的方法,4例行开放手术,2例行腹腔镜手术,术中缝合憩室颈开口,灼烧憩室腔黏膜。结果所有患者漏尿均愈合,患者无发热,无腰痛,B超显示患肾周围无积液,其中6例憩室完全消失,2例可见憩室较术前明显减小。结论肾盏憩室行去顶减压后出现的漏尿不易自行愈合,应采用手术治疗,预后较好。而术前正确诊断肾盏憩室是减少术后漏尿的关键。     

肾盏憩室结石的诊疗进展

肾盏憩室是无分泌功能的尿路上皮内衬的肾内囊性空腔,常伴有结石形成,憩室中结石的成因是代谢因素和尿流停滞的共同作用结果。其确诊则需静脉尿路造影、肾CT(平扫+强化)、逆行肾盂造影。肾盏憩室无症状时不需要治疗,但憩室直径大或合并结石时需要手术治疗。体外冲击波碎石和开放手术是既往常用的治疗手段,经皮肾镜手术及内镜途径是目前常用治疗方法,腹腔镜及机器人是新兴的治疗选择及替代方案。目前,当肾解剖存在异常时,推荐使用内镜和腹腔镜治疗。用机器人辅助腹腔镜来治疗肾盏憩室结石是安全可行的,它可以同时处理结石及憩室。     

肾盏憩室(附20例临床分析)

目的：探讨肾盏憩室的临床表现,诊断及治疗。方法：对２０例肾盏憩室病人的临床资料进行回顾性分析,并结合文献加以讨论。结果：临床表现多见尿路刺激症状,腰酸背痛,血尿。本组２０例中８例合并结石。尿路平片、Ｂ超对合并结石者诊断较好。静脉肾盂造影、ＣＴ可直接显示膨出的憩室,结论：静脉肾协造影、ＣＴ是诊断本病的首选方法,治疗依合并症选择抗感染、排石、ＥＳＷＬ或手术。     

肾窦内肾盂联合肾后下段切开治疗巨大鹿角形肾结石

目的探讨提高治疗巨大鹿角形肾结石疗效的手术方法。方法对48例巨大鹿角形肾结石患者采用肾窦内肾盂联合肾后下段切开取石术的临床资料进行总结。结果手术平均耗时180min,不需阻断肾蒂,术中平均出血300ml,巨大鹿角形肾结石全部取尽。术后2~3月复查KUB或B超,3例患者发现残余结石,直径平均<0·6cm。结论该术式依据肾动脉及其分支的解剖为基础,肾损伤小,出血少,暴露良好,易取尽结石,对巨大鹿角形肾结石疗效较好。     

膀胱憩室癌误诊1例

病例资料患者男,80岁。尿频、血尿、排尿困难1年余,加重伴尿潴留半天。查体无阳性体征。B超检查:前列腺增生。膀胱充盈,内壁不光滑,内可见点状偏强回声,膀胱右侧壁外侧可见一4.3cm×3.8cm×2.8cm欠均匀强回声,向膀胱内凸入约1.6cm×1.3cm×1.2cm,形态规则,诊断右侧膀胱壁占位可能性大。下消化道钡剂灌肠对比:回盲部、各段结肠未见异常。口服1.5%泛影葡胺1000ml2h后CT平扫+增强:回肠远端对比剂充盈欠佳。膀胱充盈,上方见一气液平面,右侧壁显著增厚。膀胱右后侧壁旁见一大小约3.5cm×3.0cm的椭圆形空腔样结构,局部腔壁不规则增厚,增强前后CT…     

Giant sigmoid diverticulum: A case report

Sigmoid colon diverticulosis is commonly seen in both the surgical outpatient and emergency departments. Rarely, these sigmoid diverticulum, which usually range from 2–3mm to 2cm in size, can enlarge to more than 10 times. This is due to a ball-valve type mechanism that traps colonic gas inside the sigmoid diverticulum causing it to gradually enlarge. Patients with a giant sigmoid diverticulum (GSD) must be investigated thoroughly as two per cent of patients will present with a colonic carcinoma either within or distal to the GSD. Clinical symptoms of a GSD can range from chronic abdominal pain, altered bowel habits, abdominal distention, weight loss, bleeding, perforation, fistula formation, or bowel obstruction. CT and plain abdominal x-ray is the investigation of choice for its diagnosis. Barium enema is useful to determine the presence of a carcinoma within the GSD. Sigmoidoscopy is useful to rule out a distal colonic carcinoma. This is the first published case where nocturnal diarrhoea is the primary differentiating symptom in the patient. The treatment of choice for a GSD is complete resection of the diverticulum and/or the adjacent sigmoid colon. This can be performed with a primary anastomosis or a double-stage procedure.     

A case of coconut bezoar and Meckel's diverticulum

A 23-year-old male, operated upon for supposed pelvic appendicitis, was found to have a Meckel''s diverticulum with intestinal obstruction due to a coconut bezoar.     

小肠多发憩室致肠梗阻1例

患者男,54岁。因“反复发作腹部疼痛二月伴疼痛加重腹胀12小时”入院。既往无手术及外伤史。查体：T36．2℃、P80次／分、R22次／分、Bp130／80mmHg。痛苦貌,消瘦,神智清,扶人病房,腹部膨隆,不均匀对称,见肠型,腹壁浅静脉无扩张,腹部软,脐周压痛,无反跳痛,     

Pharyngoesophageal (Zenker's) diverticulum: case report

Pharyngoesophageal pulsion diverticulum is the most common of all oesophageal diverticuli and is characterised by dysphagia, regurgitation, gurgling sounds in the neck and aspiration. This is a report of an 80-year old female who presented with progressive dysphagia, weight loss and recurrent bouts of pneumonitis. A barium swallow showed a pharyngoesophageal diverticulum and an upper endoscopy confirmed a wide ostium and no other pathology. She underwent surgical pharyngoesophageal diverticulectomy and cricopharyngeal myotomy under general anaesthesia and made complete recovery with total relief of dysphagia.