篇名 | Bilateral Hydronephrosis Caused by Intravesical Foreign Body: A Case Report |
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卷期 | 16:1 |
並列篇名 | 膀胱內異物造成雙側腎水腫--病例報告 |
作者 | 黃逸修 、 郭俊逸 、 陳光國 、 邱文祥 、 張心湜 |
頁次 | 021-023 |
關鍵字 | 膀胱內異物 、 腎水腫 、 阻塞性腎病變 、 Intravesical foreign body 、 Hydronephrosis 、 Obstructive uropathy |
出刊日期 | 200503 |
一名雙側腎水腫及急性腎衰竭之七十六歲男性病患,於置入雙側腎造瘻管後,順行性腎盂攝影顯示雙側下段輸尿管狹窄,經KUB及超彰波檢查發現膀胱內有一異物,電腦斷層顯示此異物穿過膀胱壁進入腹腔,經手術取出此異物發現爲一斷裂且被結石包覆之尿管。術後成功的拔除雙側腎造瘻管且超音波顯示雙側輕微腎水腫。此病患的雙側輸尿管狹窄可能導因於膀胱內異物造成的膀胱壁發炎,因此,在取出此異物後腎水腫得以緩解進而成功地拔除腎造瘻管。
We report on a 76-year-old man with bilateral hydronephrosis and acute renal failure initially managed with a bilateral percutaneous nephrostomy (PCN). An antegrade pyelogram showed bilateral stricture of the lower ureters. A foreign body was found in the urinary bladder by kidney-ureter-bladder (KU B) film and sonography. Computed tomography revealed that the object had penetrated the urinary bladder wall into the peritoneal cavity. On surgical exploration, we found a stone-encrusted disrupted Foley catheter. Postoperatively, sonography revealed mild residual hydronephrosis. Bilateral ureteral stricture might have been the result of foreign body-induced inflammation of the bladder wall. However, the bilateral hydronephrosis spontaneously resolved after removal of the foreign body, after which the PCN tubes were successfully removed.