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患儿,男,8岁,发热、尿痛、尿急伴下腹痛3天以泌尿系感染收入院,既住患儿曾有间断性尿痛但能自愈,6岁曾作过双侧隐睾固定术。查体:除双侧肾脊肋处轻度叩痛外,余无阳性体征。尿常规:旦白(++)脓球(+++)血球1～2/HP。B超检查:双肾轮廓欠清,集合系统明显分离扩张,右侧约4 cm,左侧约3 cm向下追踪扫查左侧其扩张的液性暗区呈柱状巨型扩张行曲重叠最宽处约6.5 cm,右侧液性暗区向下扫查柱状行曲液性暗区约2 cm,双侧均汇集在膀胱后方,B超诊为双侧重度肾积水。排泄性肾盂造影:注76％泛影葡胺20 ml后15分钟双肾下极显影充盈良好并向下向外呈压迫性移位,上极未充盈。后行B超引导下双侧输尿管区液性暗区穿刺抽液,细胞学检查(一),抽液后注入76％泛影葡胺拍片显示:双肾上极扩张充
Children, male, 8 years old, fever, dysuria, urinary urgency with abdominal pain 3 days to urinary tract infection hospital, both children had intermittent dysuria but can heal themselves, 6-year-old had been bilateral hidden Testicular fixation. Physical examination: In addition to the bilateral renal pelvis at the light percussion pain, I no positive signs. Urine routine: white (++) pus ball (+++) blood cells 1 ~ 2 / HP. B-ultrasound: renal outline of the less clear, the collection system was significantly isolated expansion of the right about 4 cm, about 3 cm left down to scan the left side of its expansion of the liquid dark zone columnar giant expansion kinks most wide overlap At about 6.5 cm, the right liquid dark area down scanning columnar liquid curved dark area about 2 cm, both sides are collected in the bladder behind, B ultrasound diagnosis of bilateral severe hydronephrosis. Excretory pyelography: Note 76% diatrizoate 20 ml 15 minutes after the kidneys under the pole imaging well-filled and outward downward pressure was displaced, the very not filling. B-ultrasound under the guidance of bilateral ureteral fluid puncture fluid dark area, cytology (a), after infusion of 76% of the diatrizoate meglumine filming showed: