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病例報告：不完全雙套集尿系統的結石

羅偉恩、王曉暹、黃家倫、楊景偉、陳光國、張心湜、蔡昇翰、謝啟誠

振興醫療財團法人振興醫院泌尿部

Case Report: Incomplete Duplication of Collecting System with Ureteral Stone

Wei-En Luo, Hsiao-Hsian Wang, Chia-Lun Huang, Chin-Wei Yang, Kuang-Kuo Chen, Luke S. Chang, Sheng-Han Tsai, Chieh-Chen Hsieh

Department of Urology, Cheng Hsin General Hospital, Taipei, Taiwan

 

Case presentation: 

A 43 years-old female visited urology outpatient department for persisted left ureter stone with renal colic, after attempted ureteroscopy lithotripsy in other hospital 3 weeks ago. At urology clinic, KUB showed left ureteropelvic junction stone and double J catheterization in the left collecting system. Urinalysis revealed RBC = 30-49/HPF and WBC = 6-9/HPF. Abdominal CT scan revealed double J catheter in situ but not over the stone. Retrograde Intrarenal Surgery with flexible ureteroscopy was performed. Incomplete duplication of collecting system with ureteral stone impaction in the lower moiety. Lithotripsy was done with holmium laser and a 4.8 Fr 26 cm double J catheter was implanted to the collecting system. Postoperative image of KUB showed stable double J catheter in the left collecting system with no radiopaque lesions. The patient recovered well and had follow up at urology outpatient department.

  

Discussion:

  Ureteral duplication is most common in females and may be incomplete or complete. Complications of  incomplete duplication is most often associated with ureteroureteral reflux or ureteropelvic junction obstruction of the lower pole of the kidney, which may also be associated with urinary stones. Incomplete duplication of collecting system may be difficult to detect preoperatively. During endoscopic surgeries, the lesions such as urinary stones or tumors may easily be neglected. Therefore, preoperative image study such as CT urography is helpful for diagnosis.  

 

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    資料夾名稱
    摘要
    發表人
    TUA線上教育_家琳
    單位
    台灣泌尿科醫學會
    建立
    2024-01-10 13:53:06
    最近修訂
    2024-01-10 13:53:58
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