马蹄肾合并输尿管畸形伴输尿管异位一例并文献回顾

Horseshoe Kidney with Ureteral Malformation, Ectopic Ureter: A Case Report

目的:回顾性分析1例马蹄肾患儿合并输尿管畸形,异位输尿管的临床资料,并进行相关文献回顾,提高临床上对该疾病的认知。方法:1个4岁的男孩因为反复尿床于当地行B超检查提示肾脏发育异常伴输尿管异常。于我院行体格检查与实验室检查未见异常。行CTU提示:左侧输尿管畸形扩张,右侧输尿管扩张。双侧肾盂肾盏扩张。行于全麻下行双侧输尿管再植术 + 输尿管残端切除术 + 剖腹探查术。结论:马蹄肾常合并泌尿系统畸形并不少见,但该病例合并左侧输尿管畸形,右侧巨输尿管,膀胱内异位输尿管,属实少见,特进行报道,同时阐述下对于膀胱内异位的盲端输尿管如何进行判断处理。

Background: Horseshoe kidneys are mostly asymptomatic, but some patients often have other urogenital, gastrointestinal, cardiopulmonary, skeletal, or chromosomal abnormalities. We describe a 4-year-old boy with horseshoe kidney with left ureter “Y” deformity, bilateral giant ureter, ureteral ectopic and how to treat it and how to treat the ectopic blind end of the ureter in the bladder. Case presentation: A 4-year-old boy was admitted to a local hospital for frequent, dirty and interrupted urination and the B-ultrasound showed renal dysplasia with ureteral abnormalities. In our hospital, Physical examination and laboratory examination showed no abnormality. CTU suggested: left ureter malformation and dilatation, right ureter ectasia, expansion of bilateral renal pelvis and calyces, horseshoe kidney. The child underwent bilateral ureteral replantation under general anesthesia/ureteral stump excision. After a year of follow-up, a clinical examination and imaging findings were unremarkable. Conclusions: It is not uncommon for horseshoe kidneys to be associated with urinary malformation, but this case was associated with left ureter “Y” deformity, bilateral giant ureter, ureteral ectopic. This kind of case is true rare. So we carry on a report especially. We also describe the identification and management of ectopic blind ureters in the bladder.