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患者,女,16岁。因发现左上腹无痛性包块2周入院。无血尿病史。体检:营养差,消瘦,左上腹触及直径约20cm肿块,质硬、固定、不光滑,无明显压痛和叩击痛。B超:左肾区探及18.0×17.5×17cm异常回声区,结构杂乱,形态不规则,包膜完整,未显示左肾结构。提示左肾肿瘤。IVP示左肾不显影,右肾正常。逆行肾盂造影:左肾盂及输尿僻上端向外上移位,肾盂受压变形,诊断左肾肿瘤。X线胸片示膈肌左侧明显抬高。Hb9.1g/L,ESR66mm/h。临床诊断为左肾肿瘤。在硬膜外麻醉下行
Patient, female, 16 years old. Because of the discovery of left upper abdomen painless mass 2 weeks admission. No history of hematuria. Physical examination: poor nutrition, weight loss, touching the left upper abdomen about 20cm in diameter mass, hard, fixed, not smooth, no significant tenderness and percussion pain. B ultrasound: exploration of the left kidney area and 18.0 × 17.5 × 17cm abnormal echo area, structural disorder, irregular shape, complete capsule, left kidney structure is not displayed. Tip left kidney tumor. IVP showed no left kidney, right kidney normal. Retrograde pyelography: the left renal pelvis and the upper end of the ureter displaced, the renal pelvis compression deformation, the diagnosis of left kidney cancer. X-ray showed diaphragmatic left significantly elevated. Hb 9.1 g / L, ESR 66 mm / h. Clinical diagnosis of left kidney tumors. Down the epidural anesthesia