孤立性結核性輸尿管炎與輸尿管鏡檢查發現：病例報告
林憲雄1、2、盧致誠1、林嘉禾1、謝昆霖1、范文宙1、鄭哲舟1
奇美醫療財團法人柳營奇美醫院 外科部 泌尿外科1
敏惠醫護管理專科學校2
Isolated tuberculous ureteritis with ureteroscopic findings: A case report
Chian-Shiung Lin1、2, Chih-Cheng Lu1, Chia-Ho Lin 1, Kun-Lin Hsieh 1, Eric W. Fan1, Tse-Chou Cheng1
Divisions of Urology, Department of Surgery, Chi Mei Medical Center, Liouying, Tainan City, Taiwan1
Min-Hwei Junior College of Health Care Management, Tainan City, Taiwan2
Urogenital tuberculosis (TB) accounts for 15-20% of extra-pulmonary TB. Urogenital TB is characterized by varied clinical symptoms and a lack of specific clinical signs. Here we report a case of isolated tuberculous ureteritis in 56-year-old female presented with left flank soreness associated with voiding irritation syndrome for months. Abdominal Computed tomography revealed left ureteral wall thickening with hydronephrosis and ureteritis or tumor infiltration suspected. Ureteroscopy demonstrated diffuse whitish necrosis of ureteral mucosa and multiple stricture of left side ureter. Pathology of left ureteral biopsy specimen showed abundant caseating necrosis with mulinucleated giant cell formation. Acid-fast bacilli positive and mycobacterium tuberculosis was confirmed in urine TB culture. The treatment consisted of establishing a ureteral double-J stent to drain the left kidney, followed by antituberculous antibiotics.