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1 病案摘要 患者,男64y。1a前曾患左髂窝脓肿,在外院行“左髂窝脓肿切开引流加结肠吻合术”。术后因尿频、尿急、尿痛及尿流中断5mo余。曾在外院作B超检查,诊断为“膀胱结石”后来我院诊治。体检:左中下腹有一斜行手术疤痕,肋下未触及肝、脾,双肾区未见隆起及包块,无叩击痛,双侧输尿管走行区未见异常,无压痛,膀胱区压痛(+),肛门指诊,前列腺Ⅱ度增大,质硬,中央汤变浅,无压痛。逆行肾盂造影和静脉肾盂造影:未见明显的阳性结石阴影,但膀胱区前见4cm×5cm的微弯阴影,两肾盂肾盏显示良好。输尿管无扩张,膀胱左侧似充盈缺损,壁毛糙。提示:膀胱内阴影,考虑为结石。
1 case summary patient, male 64y. 1a had left iliac fossa abscess, outside the hospital “left iliac abscess incision and drainage plus colon anastomosis.” Surgery due to frequent urination, urgency, dysuria and urinary flow interrupted more than 5mo. Had a B-ultrasound in the hospital, diagnosed as “bladder stones” later hospital treatment. Physical examination: There was a skewed surgical scar in the left lower abdomen. The ribs did not touch the liver, spleen and kidney area. There was no bulge and mass percussion, no percussion pain, no abnormalities in bilateral ureteric walking area, no tenderness and tenderness in the bladder area +), Anal referral, prostate II degree increases, hard, the central soup lighter, no tenderness. Retrograde pyelography and intravenous pyelography: no significant positive shadow of the stone, but the front of the bladder see 4cm × 5cm micro-curved shadow, renal pelvis calyx shows good. No expansion of the ureter, the left side of the bladder seems to fill the defect, rough wall rough. Tip: shadow of the bladder, considered as stones.