下腔静脉后输尿管的诊治

【目的】总结下腔静脉后输尿管的诊治经验。【方法】对6例下腔静脉后输尿管患者的症状,影像学检查和治疗进行回顾性分析。【结果】6例均有右腰胀痛,2例有发作性血尿,1例继发输尿管结石且伴肾绞痛发作。诊断主要依据IVU及逆行输尿管造影,表现为肾及输尿管上段积水,呈“S”形扩张。6例均行狭窄段切除,输尿管复位成形术。随访8个月至12年,所有患者症状消失,肾积水明显减轻。【结论】对不明原因的右肾及右输尿管上段积水者应考虑到本病可能,IVU及逆行输尿管造影是主要诊断方法,狭窄段切除,输尿管复位成形术效果良好。

The Diagnosis and Treatment of Retrocaval Ureter

To summarize the experiences in diagnosis and treatment of retrocaval ureter (RU).The clinical symptoms, features of imaging examination and treatment in 6 RU patients were analyzed retrospectively.All of 6 cases had right flank pain, 2 cases with episode of hematuria, 1 case manifested secondary ureteral calculi and renal colic. The diagnosis was based mainly on intravenous urography (IVU) and retrograde ureteropyelography (RGU), showing hydronephrosis and hydroureter of upper segment with "S" shaped dilatation. Resection of stenotic segments and ureteroplasty after reduction were performed in all 6 cases. They were followed up from 8 months to 12 years, satisfactory recovery with disappearance of symptoms and distinct remission of hydronephrosis were achieved .[Conclusion]Retrocaval ureter should be considered when hydronephrosis and hydroureter of upper segment on the right side were encountered. IVU and RGU are the chief diagnostic procedures. Resection of stenotic ureteral segment and ureteroplasty after reduction will bring about good therapeutic efficacy.