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自发性尿外渗临床并非少见,但所见报告不多,常被误诊。我院自1982～1988年诊误2例,现报告如下。例1 女,42岁。因右侧持续性腹痛1天于1982年5月15日入院。体检:T38℃,满腹压痛、反跳痛,以右下腹为甚。尿常规正常。诊断为阑尾炎。行手术探查发现阑尾正常,腹腔有淡黄色液体约200ml。右输尿管髂血管上扪及花生米大结石1枚。于腹膜外行输尿管切开取石,见结石上输尿管菲薄处渗尿,取石后输尿管置“T”管、切口置“烟卷”引流,治愈。例2 男,28岁。因左腰,腹部疼痛、腹胀、呕吐2天于1988年6月22日以“麻痹性肠梗阻”入院。1年前有左腰疼、肉眼血尿史.体检:T38.8℃,腹部膨隆,满腹压痛,肠鸣音弱,叩诊有移动性浊音。左肾区饱满,叩痛。尿常规:RBC(+)。立位腹部平片见多个阶梯状液气平面,左输尿管上段见黄豆大小致密影。IVU左肾不显影。左输尿管插管17cm受阻,加钢丝支架后通过结石,逆行造影示左肾积水。腹穿抽出淡黄色液体150ml,症状减轻。1周后手术取石,治愈。
Spontaneous urinary exudation clinical is not uncommon, but few reports, often misdiagnosed. Our hospital from 1982 to 1988, 2 cases of diagnosis errors, are as follows. Example 1 Female, 42 years old. Due to the right side of one day of continuous abdominal pain in May 15, 1982 admission. Physical examination: T38 ℃, full of tenderness, rebound tenderness, right lower quadrant is even. Urine routine normal. Diagnosis of appendicitis. Surgical exploration found normal appendix, abdominal cavity pale yellow liquid about 200ml. Right ureter iliac artery palpable peanut large stones 1. In the extraperitoneal ureterotomy lithotomy, see the ureteral calculi at the fecal exudate, ureteral stone after the home “T” tube, incision set “cigarettes” drainage, cure. Example 2 male, 28 years old. Due to left lumbar, abdominal pain, bloating, vomiting 2 days in June 22, 1988 to “paralytic ileus” admission. 1 year ago, left back pain, history of gross hematuria. Physical examination: T38.8 ℃, abdomen bulging, full of tenderness, bowel sounds weak, percussion mobile dullness. Left kidney area full, percussion pain. Urine routine: RBC (+). Standing abdominal plain film see a number of ladder-like liquid level, the upper left ureteral see the size of dense soybeans. IVU left kidney does not develop. Left ureteral intubation 17cm blocked, plus steel stent through the stones, retrograde angiography showed left hydronephrosis. Abdominal wear out of a light yellow liquid 150ml, reduce the symptoms. After 1 week surgery stone, cure.