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临床资料 患儿,男性,7岁.因发现左上腹膨隆4年,于1994年6月1日入院.查体:左上腹可触及1胎头大小肿块,质软,无压痛.B超提示左腹部巨大囊性占位.CT示左肾积水达20cm×15cm×10cm,肾实质厚约3mm.行左肾穿刺造影术,示左肾巨大积水征,6h后输尿管仍不显影.膀胱镜检查示双侧输尿管开口位置正常,左侧喷尿不明显.逆行肾盂造影示左肾盂输尿管交界部(PUJ)线状狭窄,造影剂进入巨大肾盂内呈雾状散开.患儿右肾形态呈代偿性增大,功能正常.临床诊断 左侧先天性PUJ梗阻伴左肾巨大积水.
Clinical data Children, men, aged 7. Because of the left upper quadrant bulge found 4 years, admitted to hospital on June 1, 1994. Physical examination: the left upper abdomen can reach 1 fetal head mass, soft, no tenderness. Abdominal mass cystic mass.CT showed left hydronephrosis of up to 20cm × 15cm × 10cm, renal parenchyma thickness of about 3mm .Linear renal puncture angiography, showed a huge levy left renal syndrome, urethral still not developed after 6h. Check the bilateral ureteral openings showed normal position, left side of the urine is not obvious.Returnary pyelography showed left ureteropelvic junction (PUJ) linear stenosis, contrast agent into the huge renal pelvis was foggy diffuse.The shape of the right kidney in children was Compensatory increase, normal function.Conclusion Diagnosis of left congenital PUJ obstruction with massive left kidney water.