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中華民國泌尿科醫學會雜誌

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篇名 Anomalies of Urachus – Report of 21 Cases
卷期 4:3
並列篇名 臍尿管異常-21例病例報告
作者 張謙行吳宏豪陳明村陳光國林登龍張延驊徐慧興魏拙夫張心湜
頁次 1151-1158
關鍵字 urachusurachal cystTSCI
出刊日期 199309

中文摘要

本院自1975年至1992年,總計有21個病例,其中7例是孩童,14例是成人。在7例孩童中,都是由於肚臍有尿液或濃樣液流出而求診,診斷上無太大困難。至於14例成人中,有6例是以肚臍有震樣液流出合併疼痛表現,5例是以下腹痛合併腫塊之症狀表現,另有3例則是以急腹膜炎之症狀表現。而在診斷上,有9例主要是利用腹部超波診斷,3例是利用臨床症狀直接診斷,但有2例是在剖腹探查後才確定診斷。在治療上,其中有14例只接受局部大塊切除,另有7例除接受局部大塊切除外,尚接受部分膀胱切除術。在病理上均證實為臍尿管之殘留物,但有2例合併有上皮細胞不同程度之變性。所有病人開刀後,預後均十分良好。臨床醫師的警覺,早期的診斷及足夠的治療,是處理這些病人的關鍵。

英文摘要

From 1975 to 1992, a total of 21 patients with urachal anomalies, including 7 children (3 females and 4 males) and 14 adults (3 females and 11 males), were enrolled in this restrospective study. All seven children presented with urine leakage or purulent discharge from the umbilicus. These were diagnosed without difficulty. Of the 14 adult patients, 6 presented with purulent discharge from the umbilicus and periumbilical pain; 5 had lower abdominal pain and palpable abdominal mass; and the other 3 showed symptoms and signs of acute peritonitis. Urachal anomalies in nine adults were diagnosed by ultrasongraphy; in three, by clinical picture; but in two adults, diagnoses were made only after exploratory laparotomy. All patients received en bloc excision of the urachal anomalies, and seven of them underwent additional patial cystectomy. The urachal remnants were proved by pathology, but epithelial metaplasia was noted in two cases. The prognosis was good. Clinical alertness, with early diagnosis and adequate treatment, is the key point for managing these patients successfully.

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